ARA criteria for SLE

The ARA published criteria for the diagnosis of lupus in 1982. These criteria serve as a guide to information that is useful on history and physical examination. The following are criteria for the classification of systemic lupus erythematosus (SLE).

1. Malar rash
2. Discoid lupus erythematosus lesions
3. Photosensitivity (by history or observation)
4. Oral ulcers, usually painless, observed by physician
5. Arthritis-nonerosive, involving two or more joints
6. Serositis-pleuritis or pericarditis
7. Renal disorder-proteinuria (>500 mg/day) or cellular casts
8. Central nervous system disorder-seizures or psychosis (absence of known cause)
9. Hematologic disorder-hemolytic anemia, leukopenia (<4000/mm2) or thrombocytopenia (< 100,000/mm2)
10. Immunologic disorder-positive LE prep, abnormal titers of antinative (n) DNA, and anti-Sm, false-positive VDRL
11. Antinuclear antibody

If four or more criteria are present serially or simultaneously during any period of observation, the patient is considered to have SLE.

Shingles Vaccine Recommended for All Older Adults

The Centers for Disease Control and Prevention is now recommending that all adults age 60 and older receive a dose of the zoster vaccine (Zostavax), even if they have had shingles previously.

MMWR 2008

In subjects age 60 and older, use of Zostavax was found to reduce the overall occurrence of herpes zoster by roughly 50%.

For people in their 60s, the risk reduction was 64%.