Hospital-based first diagnoses of systemic sclerosis: Defining initial clinical presentations and diagnostic...

Area of Science:

• Rheumatology
• Internal Medicine
• Clinical Diagnosis

Background:

• Systemic sclerosis (SSc) diagnosis is challenging due to varied symptoms and few biomarkers.
• Late diagnosis often occurs during hospitalization, frequently with severe complications.
• This study examines SSc patients diagnosed during inpatient stays.

Purpose of the Study:

• To characterize the clinical presentation of SSc patients diagnosed during hospitalization.
• To investigate the diagnostic pathways and outcomes for these patients.
• To compare SSc patients admitted for SSc-related reasons versus those incidentally diagnosed.

Main Methods:

• Retrospective review of adult patients newly diagnosed with SSc during hospitalization (Jan 2016-Jul 2023).
• Exclusion of patients with prior outpatient SSc diagnosis.
• Comparison of clinical features between SSc-related admissions and incidental diagnoses.

Main Results:

• 35 patients included; 68.6% incidentally diagnosed during hospitalization for other conditions.
• Common admission reasons: pericardial effusion, pulmonary hypertension, interstitial lung disease.
• Similar outcomes and demographics between groups, except for more GI involvement in incidentally diagnosed patients (P=0.02).

Conclusions:

• Hospitalized patients diagnosed with SSc often present with diffuse skin involvement and advanced cardiopulmonary issues.
• Incidental diagnosis during hospitalization for unrelated conditions is common.
• Increased clinical vigilance and systematic SSc screening in at-risk hospitalized patients are crucial for early detection and improved outcomes.