Division of Rheumatology, Department of Medicine III, University Medical Center and Faculty of Medicine Carl Gustav Carus, Technical University of Dresden, Dresden, Germany.
Division of Rheumatology, Department of Medicine, Toronto Western Hospital, Mount Sinai Hospital.
Rheumatology (Oxford). 2020 Dec 5;59(Suppl5):v4-v11. doi: 10.1093/rheumatology/keaa379.
The EULAR/ACR 2019 classification criteria for SLE constitute a current and optimized clinical approach to SLE classification. Classification is still not based on molecular approaches and the results from large studies using polyomics may be interpreted as demonstrating the relevance of the genetic and environmental background rather than splitting SLE into several entities. In fact, an association study within the EULAR/ACR classification criteria project found associations between manifestations only within organ domains. This independency of various organ manifestations argues for SLE as one disease entity. The current review article will therefore concentrate on the clinical and immunological manifestations of SLE and on what we have already learned in this century. Moreover, the structure and essential rules of the EULAR/ACR 2019 classification criteria will be discussed. While classification and diagnosis are distinct concepts, which have to remain clearly separated, information derived from the process towards the classification criteria is also useful for diagnostic purposes. Therefore this article also tries to delineate what classification can teach us for diagnosis, covering a wide variety of SLE manifestations.
EULAR/ACR 2019 年 SLE 分类标准构成了 SLE 分类的当前和优化的临床方法。分类仍然不是基于分子方法，并且使用多组学的大型研究结果可能被解释为证明遗传和环境背景的相关性，而不是将 SLE 分为几个实体。事实上，EULAR/ACR 分类标准项目中的一项关联研究发现，仅在器官域内存在表现之间的关联。这种各种器官表现的独立性表明 SLE 是一种疾病实体。因此，本期综述文章将集中讨论 SLE 的临床和免疫学表现，以及我们在本世纪已经学到的内容。此外，还将讨论 EULAR/ACR 2019 年分类标准的结构和基本规则。虽然分类和诊断是不同的概念，必须明确区分，但从分类标准制定过程中获得的信息也可用于诊断目的。因此，本文还试图阐明分类对诊断的启示，涵盖了广泛的 SLE 表现。
