SLEの分類基準：Updating the American College of Rheumatology revised criteria (1997)
Malar rash （頬部紅斑）
Fixed erythema, flat or raised, over the malar eminences, tending to space
the nasolabial folds
Discoid rash （円板状皮疹）
Erythematous raised patches with adherent keratotic scalling and follicular
plugging; atrophic scarring may occur in older lesions
Photosensitivity （日光過敏）
Skin rash as a result of unusual reaction to sunlight, by patient history
or physician observation
Oral ulcers （口腔潰瘍）
Oral or nasopharyngeal ulceration, usually painless, observed by a physician
Arthritis （関節炎）
Nonerosive arthritis involving 2 or more peripheral joints, characterized
by tenderness, swelling, or effusion
Serositis （しょう膜炎）、 以下の a, b のいずれか
Pleuritis- convincing history of pleuritic pain or rub heard by a physician
or evidence of pleural effusion
Pericarditis- documented by ECG or rub or evidence of pericardial effusion
Renal disorder （腎障害）、 以下の a, b のいずれか
Persistent proteinuria greater than 0.5 grams per day or greater than 3+ if
quantitation not performed
Cellular casts- may be red cell, hemoglobin, granular, tubular, or mixed
Neurologic disorder （神経障害）、 以下の a, b のいずれか
Seizures- in the absence of offending drugs or known metabolic derangements,
e.g., uremia, ketoacidosis, or electrolyte imbalance
Psychosis- in the absence of offending drugs or known metabolic derangements,
e.g., uremia, ketoacidosis, or electrolyte imbalance
Hematologic disorder （血液異常）、 以下の a-d のいずれか
Hemolytic anemia- with reticulocytosis
Leukopenia- less than 4,000/mm3 total on 2 or more occasions
Lymphopenia- less than 1,500/mm3 on 2 or more occasions
Thrombocytopenia- less than 100,000/mm3 in the absence of offending drugs
Immunologic disorder （免疫異常）、 以下の a-d のいずれか
Anti-DNA: antibody to native DNA in abnormal titer
Anti-Sm: presence of antibody to Sm nuclear antigen
Positive finding of antiphospholipid antibodies on:
an abnormal serum level of IgG or IgM anticardiolipin antibodies,
a positive test result for lupus anticoagulant using a standard method, or
a false-positive test result for at least 6 months confirmed by Treponema
pallidum immobilization or fluorescent treponemal antibody absorption test
Antinuclear antibody （抗核抗体）
An abnormal titer of antinuclear antibody by immunofluorescence or an equivalent
assay at any point in time and in the absence of drugs known to be associated
with " drun-induced lupus" syndrome
** 上記4項目以上でSLEと分類する（出現時期は一致しなくともよい）
** sensitivity 96%, specificity96%
** 【出典】Eng M. Tan, et al. The 1982 revised criteria for the classification
of systemic lupus erythematosus. Arthritis Rheum. 25: 1271-1277, 1982
** 【出典】Hochberg MC. Updating the American College of Rheumatology revised
criteria for the classification of systemic lupus erythematosus. Arthritis Rheum.
40: 1725, 1997.
** 判定：合計5項目以上（大項目2項目以上）
** 除外項目：Ⅰ 感染症、Ⅱ 悪性腫瘍、Ⅲ 膠原病
** 【出典】Yamaguchi M, et al. Preliminary criteria for classification of adult
Still's disease. J. Rheumatol. 19: 424-430, 1992.
Fautrelらの基準（2002）
Major Criteria
Minor Criteria
･Arthralgia
･Macropapular rash
･Transient erythema
･Leukocytes>10000/mm3
･Pharyngitis
･PMN>80%
･Glycosilated ferritin<20%
** PMN: polymorphonuclear neutrophil
** 4 or more major criteria または、3 major criteria + 2 minor criteria
** 【出典】Fautrel B, et al. Proposal for a New Set of Classification Criteria
for Adult-Onset Still Disease. MEDICINE 81: 194-200, 2002.
▼再発性多発軟骨炎（Relapsing polychondritis: RP）の診断基準
RPの診断基準：McAdamsらの基準（1976）
Major diagnostic criteria for relapsing polychondritis (3 of 6 recommended
to be present)
Recurrent chondritis of both auricles
Nonerosive inflammatory polyarthritis
Chondritis of nasal cartilage
Inflammation of ocular structures including conjunctivitis, keratitis, scleritis/episcleritis,
and uveitis
Chondritis of the respiratory tract involving laryngeal and tracheal cartilages
Cochlear or vestibular damage manifested by neurosensory hearing loss, tinnitus,
and vertigo
** 【出典】L.P.McAdam, M.A.O'Hanlan, R.Bluestone and C.M.Pearson. Relapsing
polychondritis: prospective study of 23 patients and a review of the literature.
Medicine. 55,pp.:193-215 1976.
Depression and/or loss of weight （抑うつ症状および/または体重減少）
Upper arm tenderness bilaterally （両側上腕部筋の圧痛）
** 上記7項目中3項目以上、または上記の1項目以上および臨床的・病理的に側頭動脈の以上を認めた場合
** 【出典】H.A. Bird, W.Esselinckx, A.St.J.Dixon, A.G.Mowat, P.H.N.Wood. An
evaluation of criteria for polymyalgia rheuatica. Annals of the Rheumatic Diseases.
38:434-439 1979.
Chuangらの基準
Patients aged 50 years or older
Bilateral aching and stiffness persisting for 1 month or more involving two
of the following areas: neck or torso, shoulders or proximal regions of the arms,
and hips or proximal aspects of the thighs
ESR greater than 40 mm/h
Exclusion of other diagnoses except giant-cell arteritis
** The presence of all these criteria defines diagnosis of polymyalgia rheumatica.
Healeyの基準
Persistent pain (for at least 1 month) involving two of the following areas:
neck, shoulders, and pelvic girdle
Morning stiffness lasting more than 1 h
Rapid response to prednisone (-20 mg/day)
Absence of other diseases capable of causing the musculoskeletal symptoms
Age older than 50 years
ESR greater than 40 mm/h
** The diagnosis of polymyalgia rheumatica is made if all the above criteria are
satisfied.
本邦PMR研究会の診断基準（1985）
赤沈の亢進（40mm以上）
両側大腿部筋痛
食欲減退、体重減少
発熱（37℃以上）
全身倦怠感
朝のこわばり
両側上腕部筋痛
** 60歳以上、上記7項目中3項目以上でdefiniteとする。
** 本邦PMR研究会
Kyleらの診断基準（1993）
筋力低下のない肩や下肢帯の原発性筋痛
朝のこわばり（関節でなく筋肉）
無治療で少なくとも2ヶ月持続
赤沈30mm/hr以上またはCRP6mg/dl以上
関節炎や悪性腫瘍の除外
その他の筋疾患の除外
ステロイドの全身投与に速やかにかつ劇的に反応
** 【出典】V.Kyle, B.L.Hazleman. The clinical laboratory course of polymyalgia
rheumatica/giant cell arteritis after the first two months of treatment. Annals
of the Rheumatic Diseases. 52:847-850 1993.