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应对系统性红斑狼疮全球诊断和治疗延迟的挑战。

Addressing the challenge of global delays in diagnosis and treatment of systemic lupus erythematosus.

作者信息

Pons-Estel Guillermo J, Ramírez-Flores María Fernanda, Quintana Rosana, Bae Sang-Cheol, Dey Dzifa, Pons-Estel Bernardo A, Peláez-Ballestas Ingris

机构信息

Grupo Oroño - Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Rosario, Argentina.

Universidad Nacional Autónoma de México, Programa de Estudios Combinados en Medicina (PECEM), Facultad de Medicina, Mexico City, Mexico.

出版信息

Nat Rev Rheumatol. 2025 Jul 21. doi: 10.1038/s41584-025-01277-y.

Abstract

Systemic lupus erythematosus is a complex and increasingly prevalent disease that presents substantial challenges in both diagnosis and management. Diagnostic delays frequently lead to irreversible organ damage, and remain a crucial concern, mainly among vulnerable populations, such as minority ethnic groups and those living in the global south. These delays are exacerbated by the clinical heterogeneity of systemic lupus erythematosus, the lack of specific diagnostic biomarkers, gaps in disease awareness or medical training, and persistent health care disparities, particularly in low-resource settings. This Perspective highlights the urgent need for a standardized definition of diagnostic delay that accounts for both clinical and socio-economic factors. By prioritizing early intervention and expanding access to specialized care, we can improve patient outcomes and reduce the long-term burden of the disease.

摘要

系统性红斑狼疮是一种复杂且日益普遍的疾病,在诊断和管理方面都面临着重大挑战。诊断延误常常导致不可逆转的器官损伤,仍然是一个关键问题,主要存在于弱势群体中,如少数族裔群体和生活在全球南方的人群。系统性红斑狼疮的临床异质性、缺乏特异性诊断生物标志物、疾病认知或医学培训方面的差距以及持续存在的医疗保健差异,尤其是在资源匮乏地区,都加剧了这些延误。本观点强调迫切需要一个标准化的诊断延误定义,该定义要兼顾临床和社会经济因素。通过优先考虑早期干预并扩大获得专科护理的机会,我们可以改善患者的治疗结果并减轻该疾病的长期负担。

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