Lupus & antiphospholipid syndrome
From first symptoms to diagnosis of systemic lupus erythematosus: mapping the journey of patients in an observational study
Authors' conclusion
Diagnosis of SLE is delayed by more than 6 months in three quarters of patients and is associated with more damage accrual.
Study context
- Population
- Systemic lupus erythematosus (SLE) patients with disease duration <6 years
- Participants
- 275 patients
- Outcome
- Total diagnostic delay from symptom onset to SLE diagnosis (early diagnosis: within 6 months of symptom onset)
Methodological detailsData collected from patient charts, interviews and in-person clinical visits
- Data collected from patient charts, interviews and in-person clinical visits
Main finding
As reported in the abstract
Total delay, symptom onset to SLE diagnosis
Median (IQR) total delay, months
24
54
Early diagnosis (within 6 months)
28.4%
Diagnosed after 12 months
55.6%
Average number of different physicians consulted before diagnosis
3
Observational data: associations, not effects.
Further findings
Most common initial symptoms
- Arthritis/arthralgia
- 74.5%
- Rashes
- 61.8%
Factors independently associated with delayed diagnosis
- Oral ulcers as initial symptom, OR
- 3.55 (95% CI 1.45-8.70)
- Malar rash as initial symptom, OR
- 1.99 (95% CI 1.00-3.94)
- First medical assessment by orthopaedic, OR
- 5.18 (95% CI 1.47-18.20)
Delayed diagnosis and increased SDI at diagnosis
- Increased SDI at diagnosis, OR
- 2.42 (95% CI 1.03-5.69)
- Attributed mainly to neuropsychiatric and thrombotic events
Original publication
From first symptoms to diagnosis of systemic lupus erythematosus: mapping the journey of patients in an observational study. Clin Exp Rheumatol. Published 18 December 2021. doi:10.
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