Comparative evaluation of three classification criteria of systemic lupus erythematosus in pediatric patients

Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic, autoimmune, multisystemic disease with a difficult diagnosis, for which classification criteria llave been established and periodically revised. Objective: To compare the SLE classification criteria established by ACR 1997, with the SLICC 2012 criteria and the EULAR/ACR 2019 criteria in pediatric patients. Methodology: The three classification criteria indicated were applied to patients with pediatric SLE at the beginning of treatment. Results: Thirty patients were included because they met all parameters of the three classification criteria. In ACR 1997 the most common criteria were photosensitivity, malar rash, joint and hematological involve- ment; the SLICC 2012 criteria highlighted acute cutaneous lupus, synovitis, and renal involvement, and the EULAR/ACR criteria highlighted musculoskeletal, constitutional, mucocutaneous, and serous involvement. For the immunological criteria, all patients had 100% ANA (+) and 93.3% Anti-DNA (+). Conclusions: The three classification criteria are useful in clinical practice. The SLICC 2012 criteria cover many manifestations not included in the ACR 1997 criteria. The assignment of weighted scores in the domains of the EULAR/ACR 2019 criteria facilitate the diagnosis of oligosymptomatic patients and allow the evaluation of protocolized studies.