| Ilena Rose 2005-08-12, 11:55 am |
| Thanks KKJ:
http://www.rheumatology.org/publica...ate.asp?aud=mem
Updating the American college of Rheumatology Revised Criteria for the
Classification of Systemic Lupus Erythematosus
To the Editor:
In 1982, the Diagnostic and Therapeutic Criteria Committee of the
American college of Rheumatology (ACR)published revised criteria for
the classification of systemiclupus erythematosus (SLE) (1). During
the ensuing decade several investigators, including Drs. Graham Hughes
and Donato Alarcon-Segovia, among others, have described the presence
and clinical associations or antiphospholipid antibodies in patients
with SLE, as well as the occurrence of theprimary antiphospholipid
syndrome (2-5). In 1992, Piette and colleagues suggested that the ACR
revised criteria be reevaluated in light of the above discoveries (6).
At the request of Dr. Eng Tan, the Diagnostic and Therapeutic Criteria
Committee of the ACR reviewed the 1982 revised criteria for SLE and
recommended tne following revisions to criterion number 10
("Immunologic disorder"),which were approved by the Council on
Research and the Board of Directors:
1. Delete item 10(a) ("Positive LE cell preparation"), and
2. Change item lO(d) to "Positive finding of antiphospholipid
antibodies based on 1) an abnormal serum level of IgG or IgM
anticardiolipin antibodies, 2) a positive test result for lupus
anticoagulant using a standard method, or 3) a false-positive
serologic test for syphilis known to be positive for at least 6 months
and confirmed by Treponema pallidum immobilization or fluorescent
treponemal antibody absorption test."Standard methods should be used
in testing for the presence of antiphospholipid (7-10). Publication of
this letter will allow basic and clinical investigators in SLE to not
only use, but also cite, the modification of the 1982 criteria.Marc C.
Hochberg, MD, MPH for the Diagnostic and Therapeutic Criteria
Committeee of the American college of Rheumatology1. Tan EM, Cohen AS,
Fries JF, Masi AT, McShane DJ, RothfieldNF, Schaller JG, Talal N,
Winchester RJ: The 1982 revised criteria for the classification of
systemic lupus erythematosus. Arthritis Rheum 25:1271-1277, 1982
2. Harris EN, Gharavi AK, Boey M, Patel BM, Mackworth-Young CG, Loizou
S, Hughes GRV: Anticardiolipin antibodies: detection by
radioimmunoassay and association with thrombosis in systemiclupus
erythematosus. Lancet 2:1211-1214, 19833. Alarcon-Segovia D, Deleze M,
Oria CV, Sanchez-Guerrero J, Gomez-Pacheco L, Cabiedes J, Fernandez A,
Ponce de Leon S: Antiphospholipid antibodies and the antiphospholipid
syndrome in systemic lupus erythematosus: a prospective analysis of
500 consecutive patients. Medicine (Baltimore) 68:353-365, 19894.
Asherson RA, Khamashta MA, Ordi-Ros J, Derksen RHWM, Machin SJ,
Barquinero J, Out HH, Harris EN, Vilarde-Torres M, Hughes GRV: The
primary antiphospholipid syndrome: major clinical and serological
features. Medicine (Baltimore) 68:366374, 19895. Alarcon-Segovia D:
Antiphospholipid syndrome within systemic lupus erythematosus.
3:289-291, 19946. Piette JC, Wechsler B. Frances C, Godeau P: Systemic
lupus erythematosus and the antiphospholipid syndrome: reflections
about the relevance of ARA criteria. J Rheumatol 19:1835-1837, 19927.
Harris EN, Gharavi AK, Patel BM, Hughes GRV: Evaluation of the
anticardiolipin antibody test: report of an international workshop
held 4 April 1986. Clin Exp Immunol 68:215-222, 1987 8.. Harris EN,
Phil M: The second international anticardiolipin standardization
workshop: The Kingston Antiphospholipid Antibody Study (KAPS) Group.
Am J Clin Pathol 94:474-484, 19909. Exner T, Triplett DA, Taberner D,
Machin SJ: Guidelines fortesting and revised criteria for lupus
anticoagulants: Subcommitteefor the Standardization of Lupus
Anticoagulants. Thromb Haemost 65:320-322, 199110. Brandt JT, Triplett
DA, Alving B. Scharrer I: Scientific and Standardization Committee
Commumcations: criteria for the diagnosis of lupus anticoagulants—an
update. Thromb Haemost 74:1185-1190, 1995
Hochberg MC. Updating the American college of Rheumatology revised
criteria for the classification of systemic lupus erythematosus
[letter]. Arthritis Rheum 1997;40:1725.
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