SLEDAI-2K Calculator

Score all 24 SLEDAI-2K descriptors over the preceding 10 days, with organ-system subtotals that show where the 105 available points actually sit.

Last updated 18 Sep 2026

SLEDAI-2K

24 descriptors → 0–105

Seizure — 8Recent onset. Exclude metabolic, infectious or drug causes.

Psychosis — 8Altered ability to function normally from a severe disturbance in the perception of reality. Exclude uraemia and drug causes.

Organic brain syndrome — 8Altered mental function with impaired orientation, memory or other intellectual function, of rapid onset and fluctuating. Exclude metabolic, infectious or drug causes.

Visual disturbance — 8Retinal changes of SLE — cytoid bodies, retinal haemorrhages, serous exudate or choroidal haemorrhage, or optic neuritis. Exclude hypertension, infection and drug causes.

Cranial nerve disorder — 8New onset of a sensory or motor neuropathy involving a cranial nerve.

Lupus headache — 8Severe persistent headache, which may be migrainous, but must be unresponsive to narcotic analgesia.

Cerebrovascular accident — 8New onset of a stroke. Exclude arteriosclerosis.

Vasculitis — 8Ulceration, gangrene, tender finger nodules, periungual infarction, splinter haemorrhages, or biopsy or angiographic proof.

Arthritis — 4More than 2 joints with pain and signs of inflammation — tenderness, swelling or effusion.

Myositis — 4Proximal muscle aching or weakness with a raised creatine kinase or aldolase, electromyogram changes, or biopsy showing myositis.

Urinary casts — 4Haem-granular or red cell casts.

Haematuria — 4More than 5 red cells per high-power field. Exclude stone, infection and other causes.

Proteinuria — 4More than 0.5 g per 24 hours. SLEDAI-2K counts new, recurrent or persistent proteinuria.

Pyuria — 4More than 5 white cells per high-power field. Exclude infection.

Rash — 2Inflammatory-type rash. SLEDAI-2K counts the presence of any rash, not only a new one.

Alopecia — 2Abnormal patchy or diffuse hair loss. SLEDAI-2K counts persistent alopecia.

Mucosal ulcers — 2Oral or nasal ulceration. SLEDAI-2K counts persistent ulceration.

Pleurisy — 2Pleuritic chest pain with a pleural rub, effusion or pleural thickening.

Pericarditis — 2Pericardial pain with at least one of a rub, an effusion, or ECG or echocardiographic confirmation.

Low complement — 2A fall in CH50, C3 or C4 below the laboratory’s lower limit of normal.

Increased DNA binding — 2Raised DNA binding by Farr assay, above the laboratory’s normal range.

Fever — 1Above 38 °C. Exclude infective causes.

Thrombocytopenia — 1Platelets below 100 × 10⁹/L. Exclude drug causes.

Leukopenia — 1White cells below 3 × 10⁹/L. Exclude drug causes.

14of 105 pointsExample

Active SLE over the past 10 days: arthritis in four joints, an inflammatory rash, diffuse alopecia, oral ulceration, low C3 and C4, and raised DNA binding. No neurological, renal or serosal involvement, no fever, normal platelets and white cells

Twenty-four descriptors, four weights

SLEDAI-2K = sum of the weights of every descriptor present at the visit or in the preceding 10 days; maximum 105

Weight 8: seizure, psychosis, organic brain syndrome, visual disturbance, cranial nerve disorder, lupus headache, stroke, vasculitis
Weight 4: arthritis, myositis, urinary casts, haematuria, proteinuria, pyuria
Weight 2: rash, alopecia, mucosal ulcers, pleurisy, pericarditis, low complement, increased DNA binding
Weight 1: fever, thrombocytopenia, leukopenia
Window: present at the time of the visit or in the preceding 10 days
The 2K change: persistent — not only new or recurrent — rash, alopecia, mucosal ulcers and proteinuria are counted

Worked example

Active SLE over the past 10 days: arthritis in four joints, an inflammatory rash, diffuse alopecia, oral ulceration, low C3 and C4, and raised DNA binding. No neurological, renal or serosal involvement, no fever, normal platelets and white cells
Arthritis → 4
Rash 2 + alopecia 2 + mucosal ulcers 2 = mucocutaneous 6
Low complement 2 + increased DNA binding 2 = 4
4 + 6 + 4 = 14 of 105 — conventionally high activity
Note the shape of it: a patient with visible disease in three systems reaches 14, while a single seizure would add 8 on its own

Where the 105 points sit

More than half the instrument is neurological and a further 15% is renal, so two organ systems own two thirds of the scale. Everything a patient can see in the mirror is worth 10 points in total — less than one seizure.
Group	Descriptors	Points available	Share of the total
Neurological	Seizure, psychosis, organic brain syndrome, visual disturbance, cranial nerve disorder, lupus headache, stroke	56	53%
Vasculitis and musculoskeletal	Vasculitis (8), arthritis (4), myositis (4)	16	15%
Renal	Urinary casts, haematuria, proteinuria, pyuria — 4 each	16	15%
Mucocutaneous and serosal	Rash, alopecia, mucosal ulcers, pleurisy, pericarditis — 2 each	10	10%
Immunological, constitutional, haematological	Low complement (2), raised DNA binding (2), fever (1), thrombocytopenia (1), leukopenia (1)	7	7%

All 24 descriptors and their weights

Eight descriptors at 8, six at 4, seven at 2 and three at 1 — 24 descriptors summing to 105, which is the published maximum. From Gladman DD, Ibañez D, Urowitz MB, J Rheumatol 2002;29(2):288–91, taken from the authors’ own data collection sheet as hosted by the journal and cross-checked against an independently hosted copy.
Weight	Descriptors
8	Seizure · Psychosis · Organic brain syndrome · Visual disturbance · Cranial nerve disorder · Lupus headache · Cerebrovascular accident · Vasculitis
4	Arthritis · Myositis · Urinary casts · Haematuria · Proteinuria · Pyuria
2	Rash · Alopecia · Mucosal ulcers · Pleurisy · Pericarditis · Low complement · Increased DNA binding
1	Fever · Thrombocytopenia · Leukopenia

SLEDAI-2K against the original SLEDAI

That is the whole difference, and it matters more than it looks: chronic active lupus with a persistent rash or persistent proteinuria scored zero for those descriptors on the original instrument and scores them on SLEDAI-2K. Studies using the two are not directly comparable in patients with persistent disease.
	SLEDAI (1992)	SLEDAI-2K (2002)
Rash, alopecia, mucosal ulcers	Counted only if new or recurrent	Counted if present, including persistently
Proteinuria	Counted only if new or recently increased	New, recurrent or persistent > 0.5 g/24 h
Everything else	Unchanged	Unchanged — same 24 descriptors, same weights, same maximum
Agreement	—	r = 0.97 against the original
Predicting mortality	—	Equivalent to the original

What the weighting does to a patient with skin and joint disease

SLEDAI-2K scores disease activity over a short, fixed window: a descriptor counts if it is present at the time of the visit or in the preceding 10 days. That window is the reason the instrument is useful at a clinic visit and the reason it is a poor summary of a year. A patient who had a serious flare six weeks ago and is now settling scores what they have today, not what they have been through. A 30-day variant of the data collection sheet also circulates and is used in some studies, so two SLEDAI-2K scores from two papers are not necessarily measuring the same window.

What separates SLEDAI-2K from the original 1992 SLEDAI is a single, consequential change: it counts persistent activity, not only new or recurrent activity. The authors modified the definitions of rash, alopecia, mucosal ulcers and proteinuria “to include the presence of any rash, alopecia, or mucosal ulcers and new, recurrent, or persistent proteinuria > 0.5 g/24 h”. On the original instrument, a patient with a malar rash that had been there for a year scored nothing for it, and a patient with grumbling stable proteinuria scored nothing for that either — which systematically under-read chronic active disease. SLEDAI-2K correlates at r = 0.97 with the original and predicts mortality equally well, so the change is small in aggregate and large in exactly the patients it was designed for.

The weighting is the instrument’s known weakness and the reason this page prints organ-system subtotals. Seven of the eight 8-point descriptors are neurological, and with vasculitis the 8-point group is 64 of the 105 available points. The four renal descriptors are 4 points each. Everything mucocutaneous and serosal — rash, alopecia, mucosal ulcers, pleurisy, pericarditis — is 2 points each, ten points in total. The consequence is concrete: a patient with extensive active cutaneous lupus, diffuse alopecia, painful oral ulceration and inflammatory arthritis in several joints scores 10, which the conventional bands call moderate activity, while a single seizure scores 8 on its own. Neither number is wrong on its own terms — a seizure is more dangerous — but a score that is flat across a patient’s quality of life is not a good measure of whether their treatment is working, and a trial powered on SLEDAI-2K change will struggle to detect a drug that is excellent for skin disease.

Two further things the number does not contain. It does not contain damage: SLEDAI-2K measures reversible activity, and irreversible damage — scarring, avascular necrosis, established chronic kidney disease, steroid cataract — is a separate instrument, the SLICC/ACR Damage Index. A patient with severe accumulated damage and no active inflammation scores 0, and that is the correct answer. And it does not contain classification: SLEDAI-2K assumes the diagnosis and says nothing about whether the patient has lupus, which is the 2019 EULAR/ACR criteria‘s job. The two are sometimes confused because they share descriptors, but a high SLEDAI-2K in a patient who does not meet the classification criteria is a reason to revisit the diagnosis, not to escalate immunosuppression. This supports a clinician’s judgement rather than replacing it. It is arithmetic on the figures entered, and it knows nothing about the patient in front of you.

Frequently asked questions

What period does SLEDAI-2K cover?

Descriptors are scored if they are present at the time of the visit or in the preceding 10 days. A 30-day variant of the data collection sheet exists and is used in some studies, so check which window a published score used before comparing.

What is the difference between SLEDAI and SLEDAI-2K?

SLEDAI-2K counts persistent activity in rash, alopecia, mucosal ulcers and proteinuria, where the original counted only new or recurrent occurrences. Everything else — the 24 descriptors, their weights and the maximum of 105 — is unchanged. The two correlate at r = 0.97 and predict mortality equally well.

What is the maximum SLEDAI-2K score?

105. Eight descriptors weigh 8, six weigh 4, seven weigh 2 and three weigh 1: 64 + 24 + 14 + 3 = 105. Scores that high are not seen in practice, because they would require simultaneous activity in every organ system at once.

Are the SLEDAI-2K activity categories validated?

Not in the sense people assume. The widely quoted categories — 0 no activity, 1–5 mild, 6–10 moderate, 11–19 high, 20 or more very high — come from textbook convention rather than from Gladman’s paper, and no primary derivation against an outcome could be found. Treat them as a shared vocabulary, not as thresholds.

Why can a patient with severe skin disease score low?

Because of the weighting. Rash, alopecia and mucosal ulcers are worth 2 points each, so a patient with all three scores 6, while a single seizure scores 8 and any one renal descriptor scores 4. More than half the available points are neurological. SLEDAI-2K ranks danger better than it ranks burden.

Does SLEDAI-2K measure damage?

No. It measures reversible disease activity over 10 days. Irreversible damage is measured separately by the SLICC/ACR Damage Index, and a patient with extensive established damage and no active inflammation correctly scores 0 on SLEDAI-2K.

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References

Gladman DD, Ibañez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol. 2002;29(2):288–91.
Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. Arthritis Rheum. 1992;35(6):630–40.
Gladman D, Ginzler E, Goldsmith C, et al. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum. 1996;39(3):363–9.
Franklyn K, Lau CS, Navarra SV, et al. Definition and initial validation of a Lupus Low Disease Activity State (LLDAS). Ann Rheum Dis. 2016;75(9):1615–21.

Medical Disclaimer: The tools and content provided here are for educational and reference purposes only. They are not intended to substitute for professional medical advice, diagnosis, or treatment. Clinical decisions should always be based on the comprehensive assessment of a qualified healthcare professional.