Morrow et al developed a score for grading disease activity in systemic lupus erythematosus (SLE). This can be used to monitor a patient over time. The authors are from University College Hospital (UCH) and Middlesex Hospital in London.
Parameters:
(1) visual analogue score for general well-being (0 excellent health, 10 cm worst imaginable)
(2) fever > 37.5 °C not due to infection
(3) lymphadenopathy not due to infection
(4) arthralgia and/or myalgia
(5) pleuritis and/or pericarditis
(6) vasculitis skin rash grade
(7) Raynaud's phenomenon activity
(8) cerebral involvement grade
(9) renal involvement grade
(10) easy bruisability and/or bleeding
(11) daily prednisolone dose
|
Parameter |
Finding |
Points |
|---|---|---|
|
VAD for general well being |
>= 5 cm |
1 |
|
|
increase > 2 cm from last visit |
1 |
|
|
neither |
0 |
|
fever |
absent |
0 |
|
|
present |
1 |
|
lymphadenopathy |
absent |
0 |
|
|
present |
1 |
|
arthralgia/myalgia |
absent |
0 |
|
|
present |
1 |
|
pleuritis/pericarditis |
absent |
0 |
|
|
present |
2 |
|
vasculitis skin rash grade |
0, 1, or 2 |
0 |
|
|
3 |
1 |
|
Raynaud's activity |
absent |
0 |
|
|
present |
1 |
|
cerebral involvement grade |
0 |
0 |
|
|
1 or 2 |
1 |
|
|
3 |
3 |
|
renal involvement grade |
0 |
0 |
|
|
1 or 2 |
1 |
|
|
3 |
3 |
|
easy bruisability/bleeding |
absent |
0 |
|
|
present |
1 |
|
daily prednisolone dose |
<= 4 mg/day |
0 |
|
|
5 to 24 mg/day |
1 |
|
|
>= 25 mg/day |
2 |
total score =
= SUM(points for all 11 parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
• The higher the score the more active the disease.
|
Total Score |
Activity |
Grade |
|
0 or 1 |
inactive |
I |
|
2 to 4 |
mild |
II |
|
5 to 7 |
moderate |
III |
|
8 to 17 |
severe |
IV |
Purpose: To evaluate a patient with systemic lupus erythematosus (SLE) using the UCH/Middlesex score.
Specialty: Immunology/Rheumatology
Objective: disease progression
ICD-10: M32,
