Correspondence on '2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus' by Aringer et al

The 2019 European League against rheumatism/American College of Rheumatology classification criteria (EULAR/ACR 2019 criteria) for systemic lupus erythematosus (SLE) has introduced a new scoring system to classify SLE.1 The EULAR/ACR 2019 criteria include positive antinuclear antibody at least once as obligatory entry criterion; followed by additive weighted criteria grouped in seven clinical and three immunological domains and weighted from 2 to 10. Patients fulfilling at least one clinical criterion and accumulating ≥10 points are classified. In validation cohort, a classification threshold score of ≥10 yielded a sensitivity similar to that of the Systemic Lupus International Collaborating Clinics (SLICC) 2012 criteria (96.1% vs 96.7%) and a specificity similar to that of the ACR 1997 criteria (93.4% vs 93.4%), demonstrating both excellent sensitivity and specificity. However, we have two concerns about its additive criteria and methodology.\n\nFirst, some gastrointestinal injuries related to SLE, especially lupus enteritis, may be underestimated. Gastrointestinal symptoms are reported to occur in more than 50% of patients with SLE at some point in the course of their disease; …