Systemic Lupus Erythematosus in Libyans: An Appraisal of The 1982 Revised Criteria for Classification

The 1982 revised criteria for classification of systemic lupus erythematosus (SLE) was evaluated in 22 Libyan patients with SLE (age: 12-45 years; sex: 2 males, 20 females). Of these patients, 14 presented with idiopathic SLE, 2 with drug-induced SLE, 4 with hematological disorders and 2 with neuropsychiatric problems. In addition, 22 patients with classical features of rheumatoid arthritis (age: 14-50 years; sex: 5 males, 17 females), 10 patients with confirmed diagnosis of chronic active hepatitis (age: 18-
52 years; sex: 4 males, 6 females) and 22 healthy Libyans (age: 12-55 years; sex: 6 males, 16 females) were included in the study for comparison with SLE. The 1982 revised criteria demands that at least 4 or more of the criteria be full-filled by a patient to be classified as having SLE. Each of our SLE patients fulfilled more than 4 or the 1982 revised criteria, although the predominant clinical features were arthralgias, malar rash, serositis and renal involvement. Of the various immunological investigations that were conducted and compared, anti-dsDNA antibody test exhibited the highest specificity for differential diagnosis of SLE. We, therefore, recommend the measurement of anti-dsDNA antibody in all cases wherever clinically appropriate regardless of the presence or absence of antinuclear antibody. The availability of anti-dsDNA test seems to be helpful in diagnosing SLE at an early stage of the disease the potential benefits of which are obvious.