{
  "abstract": "Introduction Various studies have examined the delay between the initial symptoms and clinical manifestations of systemic sclerosis (SSc), as well as its association with high morbidity and mortality rates. However, a key limitation of these studies is their reliance on the retrospective assessment of patients’ symptoms and clinical findings. Evaluating patients with a shorter duration since SSc diagnosis may yield more accurate and reliable results. This study aims to assess the initial symptoms and clinical manifestations of patients diagnosed with systemic sclerosis (SSc) within the past three years.Material and Methods 180 SSc patients diagnosed within the past three years were included from the early Systemic SclerOsis Longitudinal Assessment Registry (SOLAR) in the study. Sociodemographic characteristics and clinical features were retrieved from the database, while additional study-related data were collected using patient-reported forms provided from participating centres.Results The sociodemographic and the data related to the time process of the disease diagnosis are presented in table 1. The most common initial symptom leading to hospital admission was isolated Raynaud’s phenomenon (RP), observed in 49.7% of patients. The other frequently reported symptoms were arthralgia (12.4%), cough/dyspnea (7.9%), puffy hand (7.3%), and RP with stiffness of skin or puffy hand (6.7%) (figure 1). The most commonly consulted departments at the initial hospital visit were internal medicine (41%), primary care physicians (15.6%), dermatology (8.3%), rheumatology (7.8%), and pulmonology (6%). The median time to hospital admission was significantly longer in patients presenting with RP as the initial manifestation compared to those with non-RP symptoms (5.48 vs. 1.03 months; p<0.01). The time to diagnosis was more prolonged in patients with RP at disease onset than in those with non-RP symptoms (16.72 vs. 5.97 months; p<0.01). Notably, 61.8% of patients reported experiencing a delay in the diagnosis of SSc. The most commonly reported reasons for this delay were patients underestimating the significance of their symptoms (51.3%), failure of healthcare providers to refer patients to appropriate specialists (21.5%), and difficulties in obtaining appointments and accessing rheumatology specialists (12%).Conclusions RP is the most frequent initial symptom leading to hospital admission among SSc patients. However, delays in both hospital admission and diagnosis are more pronounced in patients presenting with RP compared to those with non-RP symptoms. These findings underscore the need for awareness regarding the clinical significance of RP as an early indicator of SSc. Educating the specialists on recognising and managing RP could improve early detection and timely diagnosis of SSc.On behalf of the SOLAR coauthors: Serdar Can Güven, Orhan Kücükşahin, Şükran Erten, Cemal Bes, Tahsin Murat Turgay, Orhan Zengin, Ali Şahin, Ahmet Karataş, Atalay DoğruAbstract OC.34 Table 1The sociodemographic, clinical features and diagnosis process of SSc patients (n=180)Abstract OC.34 Figure 1The first symptoms leading to hospital admission",
  "authors": [
    {
      "affiliations": [
        "Ufuk University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey"
      ],
      "name": "Aslihan Avanoglu Guler"
    },
    {
      "affiliations": [
        "Hacettepe University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey"
      ],
      "name": "Büsra Firlatan"
    },
    {
      "affiliations": [
        "Adana City Training Hospital, Rheumatology Department, Adana, Turkey"
      ],
      "name": "Burak Okyar"
    },
    {
      "affiliations": [
        "Hatay Mustafa Kemal University Hospital, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey"
      ],
      "name": "Gezmis Kimyon"
    },
    {
      "affiliations": [
        "Adana City Training Hospital, Rheumatology Department, Adana, Turkey"
      ],
      "name": "Emine Duygu Ersözlü"
    },
    {
      "affiliations": [
        "Basaksehir Çam and Sakura City Hospital, Rheumatology Department, Istanbul, Turkey"
      ],
      "name": "Aysenur Yilmaz"
    },
    {
      "affiliations": [
        "Marmara University Hospital, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Aysenur Avcu"
    },
    {
      "affiliations": [
        "Marmara University Hospital, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Fatma Alibaz Öner"
    },
    {
      "affiliations": [
        "Konya City Hospital, Rheumatology Department, Konya, Turkey"
      ],
      "name": "Reyhan Bilici"
    },
    {
      "affiliations": [
        "Ankara University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey"
      ],
      "name": "Mücteba Enes Yayla"
    },
    {
      "affiliations": [
        "Etlik City Training Hospital, Rheumatology Department, Ankara, Turkey"
      ],
      "name": "Mehmet Akif Baltaci"
    },
    {
      "affiliations": [
        "Gaziantep University Hospital, Department of Internal Medicine, Division of Rheumatology, Gaziantep, Turkey"
      ],
      "name": "Fatih Albayrak"
    },
    {
      "affiliations": [
        "Sivas Cumhurriyet University Hospital, Department of Internal Medicine, Division of Rheumatology, Sivas, Turkey"
      ],
      "name": "Arif Yigit"
    },
    {
      "affiliations": [
        "Gazi University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey"
      ],
      "name": "Ibrahim Karaduman"
    },
    {
      "affiliations": [
        "Gazi University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey"
      ],
      "name": "Abdülsamet Erden"
    },
    {
      "affiliations": [
        "Istanbul Faculty of Medicine Hospital, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Sirhan Amikishiyev"
    },
    {
      "affiliations": [
        "Firat University Hospital, Department of Internal Medicine, Division of Rheumatology, Elazig, Turkey"
      ],
      "name": "Gülsah Yamancan"
    },
    {
      "affiliations": [
        "Van City Training Hospital, Rheumatology Department, Van, Turkey"
      ],
      "name": "Özlem Agbuga"
    },
    {
      "affiliations": [
        "Süleyman Demirel University Hospital, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey"
      ],
      "name": "Zübeyde Ugurlu"
    },
    {
      "affiliations": [
        "Cukurova University Hospital, Department of Internal Medicine, Division of Rheumatology, Adana, Turkey"
      ],
      "name": "Övgü Biçkici"
    },
    {
      "affiliations": [
        "Cukurova University Hospital, Department of Internal Medicine, Division of Rheumatology, Adana, Turkey"
      ],
      "name": "Didem Aslan"
    },
    {
      "affiliations": [
        "Kocaeli University Hospital, Department of Internal Medicine, Division of Rheumatology, Kocaeli, Turkey"
      ],
      "name": "Ayse Çefle"
    },
    {
      "affiliations": [
        "Istanbul Faculty of Medicine Hospital, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Yasemin Yalçinkaya"
    },
    {
      "affiliations": [
        "Firat University Hospital, Department of Internal Medicine, Division of Rheumatology, Elazig, Turkey"
      ],
      "name": "Süleyman Serdar Koca"
    },
    {
      "affiliations": [
        "Dokuz Eylül University Hospital, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey"
      ],
      "name": "Merih Birlik"
    },
    {
      "affiliations": [
        "Istanbul Faculty of Medicine Hospital, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Murat Inanç"
    },
    {
      "affiliations": [
        "Etlik City Training Hospital, Rheumatology Department, Ankara, Turkey"
      ],
      "name": "Alper Sari"
    },
    {
      "affiliations": [
        "Kocaeli University Hospital, Department of Internal Medicine, Division of Rheumatology, Kocaeli, Turkey"
      ],
      "name": "Duygu Temiz Karadag"
    },
    {
      "affiliations": [
        "Marmara University Hospital, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey"
      ],
      "name": "Mustafa Erdogan"
    },
    {
      "affiliations": [
        "Hacettepe University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey"
      ],
      "name": "Ali Akdogan"
    },
    {
      "affiliations": [
        "Ufuk University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey",
        "Hacettepe University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey",
        "Adana City Training Hospital, Rheumatology Department, Adana, Turkey",
        "Hatay Mustafa Kemal University Hospital, Department of Internal Medicine, Division of Rheumatology, Hatay, Turkey",
        "Basaksehir Çam and Sakura City Hospital, Rheumatology Department, Istanbul, Turkey",
        "Marmara University Hospital, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey",
        "Konya City Hospital, Rheumatology Department, Konya, Turkey",
        "Ankara University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey",
        "Etlik City Training Hospital, Rheumatology Department, Ankara, Turkey",
        "Gaziantep University Hospital, Department of Internal Medicine, Division of Rheumatology, Gaziantep, Turkey",
        "Sivas Cumhurriyet University Hospital, Department of Internal Medicine, Division of Rheumatology, Sivas, Turkey",
        "Gazi University Hospital, Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey",
        "Istanbul Faculty of Medicine Hospital, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey",
        "Firat University Hospital, Department of Internal Medicine, Division of Rheumatology, Elazig, Turkey",
        "Van City Training Hospital, Rheumatology Department, Van, Turkey",
        "Süleyman Demirel University Hospital, Department of Internal Medicine, Division of Rheumatology, Isparta, Turkey",
        "Cukurova University Hospital, Department of Internal Medicine, Division of Rheumatology, Adana, Turkey",
        "Kocaeli University Hospital, Department of Internal Medicine, Division of Rheumatology, Kocaeli, Turkey",
        "Dokuz Eylül University Hospital, Department of Internal Medicine, Division of Rheumatology, Izmir, Turkey"
      ],
      "name": "On behalf of the SOLAR coauthors"
    }
  ],
  "title": "OC.34 From first symptom to diagnosis: initial symptoms and delays in systemic sclerosis from the early systemic sclerosis longitudinal assessment registry",
  "uid": "2c0df60a-8922-56b5-a702-77e5afa01288"
}