classification of lupus nephritis and be associated with persisting proteinuria (more than 2+). Definition 1. Malar rash Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds. 2. Discoid rash Erythematosus, raised patches with adherent kerotic scaling and follicular plugging, atrophic scarring may occur in older lesions. 3. Photosensitivity Skin rash as a result of unusual reaction to sunlight, evidenced by patient history or physician's report. 4. Oral ulcers Oral or nasopharyngeal ulceration reported by physician. 5. Arthritis Non-erosive arthritis involving two or more peripheral joints, characterised by tenderness, swelling, or effusion. 6. Serositis Pleuritis - convincing history of pleuritic pain or pleuritic rub heard by a physician or evidence of pleural effusion; or pericarditis - documented by ECG or rub or evidence of pericardial effusion. 7. Renal disorder Persistent proteinuria greater than 0.5 grams per day; or greater than 2+ if quantitation not performed; or tubular casts - may be red cell, haemoglobin, granular, cellular or mixed. 8.Neurological disorder Seizures - in the absence of offending drugs or known metabolic derangements, e.g. uraemia, ketoacidosis; or electrolyte imbalance. 9. Hematologic disorder Hemolytic anaemia - with reticulocytosis; or leucopoenia - less than 3,500/mm3 on two (2) or more occasions; or thrombocytopenia - less than 100,000mm3 in the absence of offending drugs. 10. Immunologic disorder Positive LE cell preparation; or anti-DNA: antibody to native DNA in abnormal titre; or anti-Sm: presence of antibody to Sm (Smooth Muscle) nuclear antigen; or false positive serologic test for syphilis known to be positive for at least six (6) months and confirmed by Treponema pallidum immobilisation or fluorescent treponemal antibody absorption test. 11. Antinuclear antibody An abnormal titre 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 ‘drug-induced lupus' syndrome. 12. Alopecia Diffuse thinning and fragility of the hair in the absence of other causes (such as alopecia areata, drugs, iron deficiency and androgenic alopecia). SYSTEMIC SCLEROSIS Means a Diagnosis of Systemic Sclerosis by an appropriate Registered Medical Specialist , causing the Life
BCP-TC-05/2026
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