Hi. One of the doctors who diagnosed me explained that although the ACR "4 of 11" criteria are for the SYSTEMIC form of lupus (SLE), they actually are an umbrella encompassing other subsets:
1. By definition, people with discoid lupus (DLE) meet less than 4.
2. People with drug-induced (DILE) almost always meet less than 4. They hardly ever have major organ involvement (CNS, heart, lungs, and kidneys). The autoantibodies seen in DILE are most typically anti-single-stranded DNA and anti-histone, whch are different than the ones seen most in SLE. And, if the offending drug(s) are identified and discontinued, the DILE disease process ceases: your body stops forming specific autoantibodies, although your ANA might remain positive for some time.
This came up because I fell into yet another "subset" hiding in the criteria, negative ANA with positive anti-Ro, called "Ro-lupus". (In it, people can meet < 4, 4, or > 4.) I was shocked & demanded, "How was I supposed to recognize that this possibility is embedded in the criteria?" His answer: the criteria are written in shorthand, and even many doctors don't fully understand them. Well, my response to that cannot be fully reproduced here,
, but I did mention hieroglyphics... With my best to all, Vee