Validation of “Kozhikode Criteria’ for Diagnosing SLE as a Hematological Disorder

Systemic Lupus Erythematosus (SLE) is an autoimmune disease in which cells and tissues undergo damage mediated by tissue binding auto antibodies. At its onset it may involve one organ or tissue alone or more than one organ simultaneously; over a time additional manifestations due to involvement of other tissues and organs may occur. The observations made by us have confirmed that hematological manifestations are the commonest initial presentation in SLE. The criteria used for diagnosis till 2012 were the American College of Rheumatology (ACR) Criteria. If we rely on these criteria, diagnosis is not possible or is often delayed, because the disease could be confined to one organ or tissue alone. Time required for satisfying all 4 of the 11 criteria is variable and prolonged. Moreover hematological manifestations are underrepresented in the ACR criteria. Based on the clinical observations made on patients evaluated in our tertiary center in North Kerala, an alternate diagnostic criteria named the “Kozhikode Criteria” was proposed, especially for the diagnosis of SLE when it presents with Hematological manifestations alone. The present study was an attempt to validate the same and to look for any association of diet and lifestyle to the disease.