Recent onset. Exclude metabolic, infectious, or drug causes.

Altered ability to function in normal activity due to severe disturbance in the perception of reality. Include hallucinations, incoherence, marked loose associations, impoverished thought content, marked illogical thinking, bizarre, disorganised, or catatonic behavior. Exclude uraemia and drug causes.

Altered mental function with impaired orientation, memory, or other intellectual function, with rapid onset and fluctuating clinical features, inability to sustain attention to environment, plus at least 2 of the following: perceptual disturbance, incoherent speech, insomnia or daytime drowsiness, or increased or decreased psychomotor activity. Exclude metabolic, infectious, or drug causes.

Retinal changes of SLE. Include cytoid bodies, retinal haemorrhages, serous exudates or haemorrhages in the choroid, or optic neuritis. Exclude hypertension, infection, or drug causes.

New onset of sensory or motor neuropathy involving cranial nerves.

Severe, persistent headache; may be migrainous, but must be non-responsive to narcotic analgesia.

New onset of cerebrovascular accident(s). Exclude arteriosclerosis.

Ulceration, gangrene, tender finger nodules, periungual infarction, splinter haemorrhages, or biopsy or angiogram proof of vasculitis.

≥ 2 joints with pain and signs of inflammation (i.e. tenderness, swelling, or effusion).

Proximal muscle aching/weakness, associated with elevated creatine phosphokinase/aldolase or electromyogram changes, or a biopsy showing myositis.

Haemogranular or red blood cell casts.

> 5 red blood cells/high power field. Exclude stone, infection, or other cause.

> 0.5 g/24 hours.

> 5 white blood cells/high power field. Exclude infection.

Inflammatory type rash.

Abnormal, patchy or diffuse loss of hair.

Oral or nasal ulcerations.

Pleuritic chest pain with pleural rub or effusion, or pleural thickening.

Pericardial pain with at least one of the following: rub, effusion or electrocardiogram or echocardiogram confirmation.

Decrease CH50, C3, or C4 below the lower limit of normal for testing laboratory.

Increased DNA binding by Farr assay above normal range for testing laboratory.

> 38 °C. Exclude infectious cause.

< 100,000 platelets/μL. Exclude drug causes.

< 3,000 white blood cells/μL. Exclude drug causes.