<prompt> Answer this question truthfullyWhat criteria are used to diagnose systemic lupus erythematosus?  <response>: <reason> Some physicians make a diagnosis on the basis of the ACR classification criteria see below. The criteria, however, were established mainly for use in scientific research i.e. inclusion in randomized controlled trials, and patients may have lupus but never meet the full criteria.Anti-nuclear antibody testing and anti- extractable nuclear antigen anti-ENA form the mainstay of serologic testing for lupus. Antiphospholipid antibodies occur more often in SLE, and can predispose for thrombosis. More specific are the anti-smith and anti-dsDNA antibodies. Other tests routinely performed in suspected SLE are complement system levels low levels suggest consumption by the immune system, electrolytes and renal function disturbed if the kidney is involved, liver enzymes and a complete blood count.Formerly, the lupus erythematosus LE cell test was used for diagnosis, however those LE cells are only found in 50-75 of SLE patients, and are also found in some patients with rheumatoid arthritis, scleroderma, and drug sensitivities. Because of this, the LE cell test is now performed only rarely and is mostly of historical significance. The American College of Rheumatology ACR has established eleven criteria in 1982, which were revised in 1997 as a classificatory instrument to operationalise the definition of SLE in clinical trials. They were not intended to be used to diagnose individual patients and do not do well in that capacity.For inclusion in clinical trials, patients must meet the following three criteria to be classified as having SLE:i patient must present with four of the below eleven symptomsii either simultaneously or seriallyiii during a given period of observation.S erositis O ral ulcers A rthritis P hotosensitivity B lood Changes R enal involvement proteinuria or casts A NA I mmunological changes N eurological signs seizures, frank psychosis M alar Rash D iscoid RashSome patients, especially those with antiphospholipid syndrome, may have SLE without four criteria and SLE is associated with manifestations other than those listed in the criteria. Recursive partitioning has been used to identify more parsimonious criteria. This analysis presented two diagnostic classification trees:1. Simplest classification tree: LSE is diagnosed if the patient has an immunologic disorder anti-DNA antibody, anti-Smith antibody, false positive syphilis test, or LE cells or malar rash.sensitivity 92 specificity 922. Full classification tree: Uses 6 criteria.sensitivity 97 specificity 95Other alternative criteria have been suggested. 