Recent onset seizure
Exclude metabolic, infectious, or drug causes
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Psychosis
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, and bizarre, disorganized, or catatonic behavior); exclude uremia and drug causes
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Organic brain syndrome
Altered mental function with impaired orientation, memory, or other intellectual function (with rapid onset and fluctuating clinical features), inability to sustain attention to environment, and ≥2 of the following: perceptual disturbance, incoherent speech, insomnia or daytime drowsiness, and increased or decreased psychomotor activity; exclude metabolic, infectious, or drug causes
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Visual disturbance
Retinal changes of SLE (include cytoid bodies, retinal hemorrhages, serous exudates or hemorrhages in choroid, and optic neuritis); exclude hypertensive, infectious, or drug causes
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New onset sensory or motor neuropathy involving cranial nerves
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Lupus headache
Severe, persistent headache (may be migrainous but must be nonresponsive to narcotic analgesia)
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New onset stroke
Exclude arteriosclerosis
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Vasculitis
Ulceration, gangrene, tender finger nodules, periungual infarction, splinter hemorrhages or biopsy, and angiogram proof of vasculitis
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Arthritis
≥2 joints with pain and signs of inflammation (i.e., tenderness, swelling, or effusion)
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Myositis
Proximal muscle aching/weakness associated with elevated CPK/aldolase, EMG changes, or a biopsy showing myositis
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Heme-granular or RBC urinary casts
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Hematuria
>5 RBC/high-power field; exclude stone, infection, or other cause
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Proteinuria
>0.5 g/24 hours
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Pyuria
>5 WBC/high-power field; exclude infection
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Inflammatory-type rash
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Alopecia
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Oral or nasal mucosal ulcers
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Pleuritic chest pain with pleural rub/effusion or pleural thickening
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Pericarditis
Pericardial pain with ≥1 of the following: rub, effusion, or EKG/echocardiogram confirmation
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Low complement
CH50, C3, or C4 decreased below lower limit of normal for lab
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High DNA binding
increased above normal range for lab
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Temp >100.4 °F (38°C)
Exclude infectious causes
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Platelets <100 x 109/L
Exclude drug causes
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WBC <3 x 109/L
Exclude drug causes
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