EULAR/ACR Criteria Capture More Lupus Diagnoses
PATIENTS with interstitial pneumonia with autoimmune features (IPAF) have both lung disease and signs of autoimmunity. A new retrospective study found they may be more likely to be diagnosed with systemic lupus erythematosus (SLE) when classified using EULAR/ACR criteria rather than the traditional SLICC system.
Researchers reviewed 201 patients who were initially diagnosed with IPAF between 2005 and 2019 to compare how often each classification system identified lupus. Using the SLICC criteria, 12 patients were classified as having SLE, whereas the newer EULAR/ACR criteria identified 23 cases. This difference was statistically significant (p<0.001), suggesting that the newer framework may better capture lupus features in patients presenting with autoimmune lung disease.
Implications for Clinical Diagnosis and Management
The findings underscore the potential clinical value of using EULAR/ACR criteria to detect lupus manifestations in individuals with ILD who exhibit autoimmune characteristics but fall short of traditional SLE classification. Early and accurate identification could influence treatment decisions, as patients who meet lupus criteria may benefit from therapies tailored to systemic autoimmune conditions rather than lung disease alone.
The study also highlighted the overlap between the two systems, most patients who met the SLICC lupus criteria also fulfilled the EULAR/ACR definition. However, the EULAR/ACR model appeared more sensitive to identifying those with partial or atypical autoimmune presentations, including cases involving lymphopenia and other immunologic abnormalities.
Next Steps in Autoimmune Lung Disease Research
By revealing that EULAR/ACR criteria may better classify lupus among patients with IPAF, the authors suggest that clinicians should conduct comprehensive rheumatologic evaluations when lupus-like features are present. Further multicenter studies could clarify whether these criteria improve long-term outcomes or guide therapeutic decision-making more effectively.
Reference: Martinez-Zayas G et al. Classification of systemic lupus erythematosus in patients with interstitial pneumonia with autoimmune features using two different sets of criteria. Respir Med Res. 2025;88:101206.
