SLICC/ACR Damage Index

Measure accumulated damage since onset of lupus


1.Retinal change or optic atrophy?
3.Cognitive Impairment or Major Psychosis?
4.Seizures requiring therapy for ≥6 months?
5.Cerebrovascular Accident?
6.Cranial or Peripheral Neuropathy?
7.Transverse Myelitis?
8.Estimated or Measured GFR <50%?
9.Proteinuria ≥3.5 g/24 hours?
10.End-stage renal disease?
11.Pulmonary Hypertension?
12.Pulmonary Fibrosis?
13.Shrinking Lung?
14.Pleural Fibrosis?
15.Pulmonary Infarction?
16.Angina or Coronary Artery Bypass?
17.Myocardial Infarction?
19.Valvular disease?
20.Pericarditis or Pericardiectomy?
22.Minor Tissue Loss from Peripheral Vascular Disease?
23.Significant Tissue Loss from Peripheral Vascular Disease?
24.Venous Thrombosis with Swelling, Ulceration or Venous Stasis?
25.Infarction or Resection of Bowel (below duodenum), Spleen, Liver or Gallbladder?
26.Mesenteric Insufficiency?
27.Chronic Peritonitis?
28.Stricture or Upper Gastrointestinal Tract Surgery?
29.Pancreatic Insufficiency Requiring Enzyme Replacement or with Pseudocyst?
30.Muscle Atrophy or Weakness?
31.Deforming or Erosive Arthritis?
32.Osteoporosis with Fracture or Vertebral Collapse?
33.Avascular Necrosis?
34.Scarring Chronic Alopecia?
35.Extensive Scarring of Panniculum other than Scalp and Pulp Space?
36.Skin Ulceration (excluding thrombosis)?
37.Premature Gonadal Failure?
38.Diabetes Requiring Therapy?


The systemic lupus international collaborating clinics American College of Rheumatology Damage index (SLICC/ACR DI) was developed to quantify damage that has occurred since onset of lupus.

It has been shown to be a valid measure for damage and correlates with mortality.

In this index, damage is defined a non-reversible change, not related to active inflammation, occurring since the onset of lupus, ascertained by clinical assessment and present for at least 6 months. 'Repeat' episodes mean at least 6 months apart to score 2. The same lesion cannot be scored twice.


Gladman DD, Goldsmith CH, Urowitz MB, Bacon P, Fortin P, Ginzler E, Gordon C, Hanly JG, Isenberg DA, Petri M, Nived O, Snaith M, Sturfelt G.

The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) Damage Index for Systemic Lupus Erythematosus International Comparison.

Journal of Rheumatology 2000, 27 (2): 373-6

Gladman DD, Urowitz MB, Goldsmith CH, Fortin P, Ginzler E, Gordon C, Hanly JG, Isenberg DA, Kalunian K, Nived O, Petri M, Sanchez-Guerrero J, Snaith M, Sturfelt G.

The reliability of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index in patients with systemic lupus erythematosus.

Arthritis and Rheumatism 1997, 40 (5): 809-13

The SLICC/ACR Damage Index calculator is created by QxMD.

Created by on 05/01/2016

By using this site you acknowledge that you have read, understand, and agree to be bound by our terms of use and privacy policy. All content and tools are for educational use only, are not meant to be a substitute for professional advice and should not be used for medical diagnosis and/or medical treatment.

1. Retinal change or optic atrophy?

More Information

Retinal change: Documented by ophthalmologic examination, may result in field defect, legal blindness

Optic atrophy: Documented by ophthalmologic examination

0/39 completed