For clinicians only. This tool is for healthcare professionals and clinical education only. It does not diagnose, replace clinical judgement, or replace specialist assessment. Any decisions about a patient must be based on full clinical assessment, investigations where appropriate, and current clinical guidelines.

Descriptors (last 10 days)

Seizure (recent onset, exclude metabolic/infectious/drug causes)+8

Psychosis (altered ability to function in normal activity due to severe disturbance in perception of reality)+8

Organic brain syndrome (altered mental function with impaired orientation, memory or intellect)+8

Visual disturbance (retinal changes: cytoid bodies, retinal haemorrhages, serous exudates or haemorrhages in the choroid, or optic neuritis)+8

Cranial nerve disorder (new-onset sensory or motor neuropathy involving cranial nerves)+8

Lupus headache (severe persistent headache, may be migrainous but must be non-responsive to narcotic analgesia)+8

CVA (new-onset cerebrovascular accident; exclude atherosclerosis)+8

Vasculitis (ulceration, gangrene, tender finger nodules, periungual infarction, splinter haemorrhages, or biopsy/angiogram proof)+8

Arthritis (≥2 joints with pain and signs of inflammation)+4

Myositis (proximal muscle aching/weakness with elevated CPK/aldolase, or EMG changes, or biopsy)+4

Urinary casts (heme-granular or red cell casts)+4

Haematuria (>5 RBC/HPF; exclude stone, infection, other)+4

Proteinuria (>0.5 g/24h)+4

Pyuria (>5 WBC/HPF; exclude infection)+4

New rash (new-onset or recurrent inflammatory-type rash)+2

Alopecia (new or recurrent abnormal patchy or diffuse loss of hair)+2

Mucosal ulcers (new or recurrent oral or nasal ulcerations)+2

Pleurisy (pleuritic chest pain with rub or effusion, or pleural thickening)+2

Pericarditis (pain with at least 1 of: rub, effusion, ECG, or echo confirmation)+2

Low complement (decrease in CH50, C3 or C4 below normal)+2

Increased anti-dsDNA / DNA binding+2

Fever (>38°C after excluding infection)+1

Thrombocytopenia (<100,000/mm³)+1

Leukopenia (<3,000/mm³; exclude drug causes)+1

Live result

Score

No activity

Interpretation bands vary across studies. Use local protocol and clinical judgement.

Interpretation

0 no activity · 1–5 mild · 6–10 moderate · 11–19 high · ≥20 very high

Sources

Gladman DD, Ibañez D, Urowitz MB. SLEDAI-2K. J Rheumatol. 2002.

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Dr. Ramani Arumugam

Kuala Lumpur

Consultant Rheumatologist & Internal Medicine Physician

MBBS, Manipal Academy of Higher Education, India · Masters in Internal Medicine, University Malaya

Rheumatology fellowship training · Ministry of Health Malaysia & Royal National Hospital for Rheumatic Diseases, Bath, UK

MMC 34627 · NSR 129944

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This website is for education only and does not replace medical advice.