Challenges in the diagnosis and management of SLE in India

Chatterjee, Rudrarpan; Aggarwal, Amita

doi:10.1016/j.clicom.2023.10.001

Cited by 4 publications

(1 citation statement)

References 55 publications

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“…There is a scarcity of specialised healthcare centres and professionals trained in rheumatology and nephrology, which are crucial for the management of Lupus Nephritis. This similar observation was also seen in a study done by Chatterjee R et al 12 in central India. This lack of specialised care means that many patients do not receive timely and appropriate treatment, leading to a poor outcome 13 .…”

Section: Unique Challenges In North Eastern Indiasupporting

confidence: 89%

Lupus Nephritis in Northeastern India: Navigating the complex landscape of clinical challenges and emerging healthcare opportunities

Sharma,

Sangma

2024

MRAJ

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Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease with varied manifestations, significantly impacting women and potentially leading to Lupus Nephritis (LN), a major cause of morbidity and mortality. The review article explores the unique challenges and opportunities in managing lupus nephritis (LN) in North Eastern India, a region characterised by diverse ethnicities, cultures, and socioeconomic challenges. With a higher than average prevalence of systemic lupus erythematosus (SLE) and lupus nephritis (LN), the region presents distinct epidemiological patterns, likely influenced by genetic, environmental, and lifestyle factors. The management and prognosis of LN are further complicated by the region's geographical and infrastructural limitations, including access to specialised healthcare and socioeconomic barriers, which impacts the patient’s outcome. Despite the challenges, there are emerging opportunities for improvement through innovations in healthcare delivery, governmental and non-governmental initiatives aimed at enhancing healthcare access, and the adaptation of treatment guidelines to the local context. This review article underscores the importance of region-specific research and healthcare strategies to improve care and outcome for lupus nephritis (LN) patients in North Eastern India, thus contributing to the broader understanding of the disease in diverse populations and settings.

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Section: Unique Challenges In North Eastern Indiasupporting

confidence: 89%

Lupus Nephritis in Northeastern India: Navigating the complex landscape of clinical challenges and emerging healthcare opportunities

Sharma,

Sangma

2024

MRAJ

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Myositis India: Early lessons from a patient support group in a resource‐limited setting

Aggarwal,

Bagri,

Kavadichanda

et al. 2024

Int J of Rheum Dis

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Early diagnosis of lupus: A possibilty. A multicentric study from SLE Special Interest Group (SIG) of Indian Rheumatology Association (IRA)

Shobha,

Preet Singh,

Malviya

et al. 2024

Lupus

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Introduction Systemic Lupus Erythematosus (SLE) warrants an early diagnosis and prompt management. Delay in diagnosis can result in repeated flares, permanent damage, and even death. There is a large variability in the time taken to diagnose SLE across the world. We undertook this study to determine the time taken for diagnosis of SLE in India and to identify the factors associated. Methods Patients with SLE diagnosed within the previous 1 year as per Systemic Lupus Erythematosus International Collaborating Clinics criteria (SLICC) 2012 criteria were included in a cross-sectional multicentre questionnaire-based survey. Demographic profile, self-reported socioeconomic status as per Kuppuswamy classification of socioeconomic status (version 2022) (SES), and several healthcare related parameters including referral pattern were recorded. Median time taken for diagnosis was used to demarcate early or late diagnosis and associated factors were explored. Results We included 488 patients with SLE from 10 rheumatology centres. The median time to diagnosis was 6 months Interquartile Range (IQR 3,14.7) and within 3 months in about one third [150(30.7%)]. Very early diagnosis (<1 month) was established in 78(16.0%) patients. The mean SLE Disease Activity Index (SLEDAI) at diagnosis was 10.28+7.24. In univariate analysis, an older age, lower SES, non-southern state of residence and larger family size were significantly associated with late diagnosis. In the multivariate analysis, higher SES (AOR 0.95, 95% CI: 0.92-0.98), multiple organ system involvement at initial presentation (AOR1.75 95%CI: 1.08–2.84) and place of residence in south Indian states (AOR1.92 95%CI: 1.24–2.97) had lesser odds of being associated with late diagnosis. Distance from the closest medical centre/professional did not influence the time to diagnosis. Majority of patients had first consulted a medical graduate (42.5%) or postgraduate doctor (48.2%), and referral to rheumatologist was largely done by postgraduate (65%) doctors. More than half of our patients (61%) self-finance their treatment. Conclusion Median time to diagnosis of SLE was 6 months, 1/3rd being diagnosed within 3 months and 78(16.0%) with 1 month of symptom onset. Delay in diagnosis was noted in those belonging to lower socioeconomic strata and those with single organ disease. Distance to the health care facility did not influence time to diagnosis.

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Challenges in the diagnosis and management of SLE in India

Cited by 4 publications

References 55 publications

Lupus Nephritis in Northeastern India: Navigating the complex landscape of clinical challenges and emerging healthcare opportunities

Lupus Nephritis in Northeastern India: Navigating the complex landscape of clinical challenges and emerging healthcare opportunities

Myositis India: Early lessons from a patient support group in a resource‐limited setting

Early diagnosis of lupus: A possibilty. A multicentric study from SLE Special Interest Group (SIG) of Indian Rheumatology Association (IRA)

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