Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. It affects both men and women, with a female predominance. On the other hand, many different studies have showed that disease manifestations and their severities are different in the males and females. The aim of our study was to detect whether sex variation leads to diagnostic delay.

Methods SLE patients, those admitted our outpatient clinic between January 2017 and August 2017, were enrolled in the study. 46 patients fulfilling the SLICC classification criteria for SLE and regularly followed at our rheumatology clinic were selected. At the time of enrollment, medical and pharmacological histories were collected. Patients, those have >6 months duration between starting symptoms to diagnosis, were accepted to have diagnostic delay. Statistical comparisons were made using Mann Whitney U test and chi-square tests.

Results Diagnostic delay was detected in the 25% of males and 73.8% of females (p=0.043). The diagnosis was earlier in the males compared to the females (OR: 2.7, 95% CI: 1.3 to 6.1).

Conclusion SLE is a multisystem complex autoimmune disease that often mimics symptoms of other illnesses. Many SLE manifestations such as fatigue, hair loss, arthralgia and anaemia in especially females are confounding for clinicians in the diagnostic process. Clinicians carefully investigate the diagnosis for these manifestations in males, since various frequent diseases are suspected in females. Therefore, SLE diagnosis is earlier in males compared to females.

References

1. . Oglesby A, et al. Impact of early versus late systemic lupus erythematosus diagnosis on clinical and economic outcomes. Appl Health Econ Health Policy2014;12:179–90.

2. . Boodhoo KD, et al. Impact of sex disparities on the clinical manifestations in patients with systemic lupus erythematosus: A systematic review and meta-analysis. Medicine (Baltimore)2016;95:e4272.