SLAM-2 disease activity questionnaire



SLAM-2 disease activity questionnaire

The following guidelines are given to help anchor and guide the clinician’s judgment:

• A manifestation should be attributable to SLE. It is assumed that the clinician has excluded other causes (comorbid conditions, drug side effects, etc.) When it is not possible to make the attribution with certainty, the rater should rate the manifestation as being due to lupus.

• Manifestations should be present for a significant period of time or frequency during the month prior to the evaluation. The most severe grade present during the month should be recorded.

• Within a numbered item, a patient may have more than one manifestation but only one, the most severe, should be rated.

|CONSTITUTIONAL |

| | |

|Fatigue: |Exclude depression, fibromyalgia, chronic fatigue syndrome, anemia, chronic renal disease, myopathy, etc. |

| |If fatigue is present, ask, “What activity is most difficult for you?” |

| | |

|Fever: |A history of fever without documentation and without associated symptoms such as rigors or sweats should be recorded as 1. |

| | |

| |

|INTEGUMENT |

| |

|Skin manifestations of SLE have been grouped by clinical significance. Severity is determined by body surface area (see page 14 ), scarring or scarring |

|potential (i.e., involvement of dermis), number of individual lesions per surface area, thickness of lesion and/or intensity of erythema. Any ulcer scores |

|3. |

| | |

|Photosensitive rash: |Rash associated with sunlight or ultraviolet light exposure which appears in sun-exposed areas or malar and well demarcated |

| |from other exposed areas and/or precipitates a flare of discoid or other SLE manifestations. |

|Alopecia: | |

| |Thinning of hair or increased fragility of hair due to SLE. |

| |Rate 1: if unusual hair loss with brushing or spontaneously on pillow |

| |Rate 2: if alopecia visible |

|Lupus profundus: | |

| |Rare morphological variant of discoid LE. Typical lesions are violaceous to dull red, rounded, oval, sharply outlined, |

| |elevated plaques, with indurated rolled borders. Surface covered with adherent scales. Central portions of lesions are |

| |atrophied. Histologically identified to discoid lesions. |

|Lupus panniculitis: | |

| |Subcutaneous, tender and nontender nodules most commonly on trunk or extremities. Lesions may be as large as 12cm in |

| |diameter and resolve with scarring. Lymphocytic vasculitis seen on biopsy. |

| | |

| |

|EYE |

| | |

|Cytoid bodies: |Irregular, whitish, cotton-wool exudates in vitreous. |

| | |

| |

|RETICULOENDOTHELIAL SYSTEM |

| | |

|Lymphadenopathy: |Diffuse adenopathy implies nodes in more than one region such as bilateral cervical, epitrochlea and axillary. Shotty nodes |

| |are less than 1x1.5 cm. |

SLE ACTIVITY MEASURE-2

(Present Last Month)

CONSTITUTIONAL

1. Weight Loss

0 Absent

1 ≤10% body weight

3 >10% body weight

Unknown

2. Fatigue

0 Absent

1 Little or no limit on normal activity

2 Limits normal activity

Unknown

3. Fever

0 Absent

1 37.5-38.5 C or 99.5 – 101.3 F

3 >38.5 C or > 101.3 F

Unknown

INTEGUMENT

4. Oral/nasal ulcers, periungual erythema, malar rash, photosensitive rash, or nail fold infarct

0 Absent

1 Present

Unknown

5. Alopecia

0 Absent

1 Hair loss with trauma

2 Alopecia observed

Unknown

6. Erythematous, macular or papular rash, discoid lupus, lupus profundis, or bullous lesions

0 Absent

1 50% TBA

Unknown

7. Vasculitis (leucocytoclastic vasculitis, urticaria, palpable purpura, livedo reticularis, ulcer or panniculitis)

0 Absent

1 50% TBA or necrosis

Unknown

EYE

8. Cytoid bodies

0 Absent

1 Present

3 Visual acuity 150

1 100-150

2 50-99

3 400 or < 30%

Not recorded

31. Urine sediment (per hpf)

0 Normal

1 6-10 RBC or 6-10 WBC;

or 0-3 granular or 0-3 non RBC casts;

or trace to 1+ (on dipstick)

(3 granular or >3 non RBC casts;

or 2 to 3+ (on dipstick)

(≥500 mg-3.5 g/l 24  urine protein)

3 >25 RBC or >25 WBC;

or any RBC cast;

or 4+ (on dipstick)

(>3.5 g/l 24  urine protein)

Not recorded

Total SLAM Score: ___________

|MD global VAS (Overall lupus activity) |

|Disease inactive | | |Very severe disease activity |

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