Diagnostic delays in systemic vasculitides
Auanassova A. Yessirkepov M. Zimba O. Ahmed S. Mruthyunjaya P.
June 2024Springer Science and Business Media Deutschland GmbH
Rheumatology International
2024#44Issue 61003 - 1011 pp.
Systemic vasculitides are among the less common disorders encountered in routine rheumatology practice. The low incidence and heterogeneous presentation at onset can potentially lead to delayed diagnosis. Not recognizing these in the early phase may prove detrimental, as some vasculitis may progress to a catastrophic course with major morbidity or mortality. The causes of diagnostic delay may vary among different types of vasculitis and may also be disease-, patient-, or physician-related. Disease-related factors include the myriad presentations with diverse and non-specific symptoms, mimicking other conditions like infections. In addition, some forms have prolonged prodromal phases before evident organ damage. Limited awareness among healthcare professionals, particularly outside rheumatology, and a lack of readily available diagnostic tools contribute to missed diagnoses. Delays in seeking care due to non-specific symptoms or lack of access to specialist care can worsen outcomes. The economic burden also increases with delayed diagnosis and damage accrual when the disease remains unrecognized or untreated for prolonged periods. Although the causes of vasculitis are numerous, including secondary causes, in this review, we focus on diagnostic delays in primary vasculitides and suggest potential steps to identify and treat these diseases early. These include educating both healthcare professionals and the public about the signs and symptoms of vasculitis; expanding the rheumatology workforce and facilitating timely referrals; implementing readily available and reliable tests for early detection; and streamlining care and diagnostic pathways. Such measures have the potential to improve the overall outcomes of the disease, with prolonged remission, minimal damage accrual, and improved quality of life.
Anti-neutrophil cytoplasmic antibody-associated vasculitis , Delayed diagnoses , Giant cell arteritis , Takayasu arteritis , Vasculitis
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Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
Department of Internal Medicine #2, Danylo Halytsky Lviv National Medical University, L’viv, Ukraine
Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, 751024, India
Department of Biology and Biochemistry
Department of Clinical Rheumatology and Immunology
National Institute of Geriatrics
Department of Internal Medicine #2
Department of Clinical Immunology and Rheumatology
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