Systemic Lupus Erythematosus - SLE

ARUP Consult SLE testing topic summarizing ANA as an initial but nonspecific screen, 2019 ACR/EULAR entry criterion of ANA >=1:80 (ever), follow-up autoantibodies and complements, and monitoring recommendations that emphasize anti-dsDNA and complement rather than serial ANA. Candidate notes: ANA is a recommended initial SLE screen but is not disease-specific and occurs in other CTDs, infections, malignancies, elderly, and some healthy individuals. SLE is unlikely with positive ANA unless accompanying features suggest autoimmune rheumatic disease. Further serologic testing is indicated if titers are 1:40 or higher (per this page). 2019 ACR/EULAR criteria require positive ANA at least once (ANA titer >=1:80 on HEp-2 or equivalent) as an entry criterion; a small number of SLE patients are ANA-negative. ACR recommends against subserology tests (e.g., anti-dsDNA, anti-Smith) when ANA is negative and there are no clinical indications of autoimmune disease. Monitoring guidance cited includes C3/C4, anti-dsDNA, CBC, creatinine, and urinalysis on intervals (not routine serial ANA for activity). Limits noted in the record: Synthesizes multiple guidelines; classification criteria are for classification/research, not standalone clinical diagnosis. A positive ANA is not a diagnosis. Claims in this record are not verified.

A positive ANA is not a diagnosis. Claims in this record are not verified.

source