The ACR classification criteria for headache disorders in SLE fail to classify certain prevalent headache types

Area of Science:

• Rheumatology
• Neurology
• Clinical Epidemiology

Background:

• Headache is a frequent symptom in systemic lupus erythematosus (SLE).
• The prevalence and characteristics of headaches in SLE patients compared to the general population are not well-established.
• Current American College of Rheumatology (ACR) headache classification criteria are limited and lack specificity.

Purpose of the Study:

• To compare the performance of International Headache Society (IHS) and ACR classification criteria for headache disorders in patients with SLE.
• To evaluate the adequacy of existing headache classification systems in SLE cohorts.

Main Methods:

• A cohort of 61 patients with SLE experiencing headaches was studied.
• Headache diagnoses were classified using both the IHS and ACR criteria.
• The ability of each classification system to categorize all observed headache disorders was assessed.

Main Results:

• The IHS criteria successfully classified all headache disorders within the SLE cohort.
• The ACR criteria failed to classify 22% of the headache disorders observed in SLE patients.
• This highlights a significant limitation in the current ACR diagnostic framework for headaches in this population.

Conclusions:

• The IHS classification system is more comprehensive and effective for diagnosing headaches in SLE patients.
• The ACR headache classification criteria require revision to adequately address headache disorders in SLE.
• It is recommended to utilize IHS criteria for future research on headaches in SLE.