{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:24:47Z","timestamp":1791645887243,"version":"4.3.4"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T00:00:00Z","timestamp":1543190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2019,1]]},"abstract":"Objective<\/jats:title>Systemic lupus erythematosus (SLE<\/jats:styled-content>) presents with nonspecific signs and symptoms that are also found in other conditions. This study aimed to evaluate manifestations at disease onset and to compare early SLE<\/jats:styled-content> manifestations to those of diseases mimicking SLE<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Academic lupus centers in Asia, Europe, North America, and South America collected baseline data on patients who were referred to them during the previous 3 years for possible SLE<\/jats:styled-content> and who had a symptom duration of <1 year. Clinical and serologic manifestations were compared between patients diagnosed as having SLE<\/jats:styled-content> and those diagnosed as having SLE<\/jats:styled-content>\u2010mimicking conditions. Diagnostic performance of the 1997 American College of Rheumatology (ACR<\/jats:styled-content>) SLE<\/jats:styled-content> classification criteria and the 2012 Systemic Lupus International Collaborating Clinics (SLICC<\/jats:styled-content>) SLE<\/jats:styled-content> classification criteria was tested.<\/jats:p><\/jats:sec>Results<\/jats:title>Data were collected on 389 patients with early SLE<\/jats:styled-content> and 227 patients with SLE<\/jats:styled-content>\u2010mimicking conditions. Unexplained fever was more common in early SLE<\/jats:styled-content> than in SLE<\/jats:styled-content>\u2010mimicking conditions (34.5% versus 13.7%, respectively; P<\/jats:italic> < 0.001). Features less common in early SLE<\/jats:styled-content> included Raynaud's phenomenon (22.1% versus 48.5%; P<\/jats:italic> < 0.001), sicca symptoms (4.4% versus 34.4%; P<\/jats:italic> < 0.001), dysphagia (0.3% versus 6.2%; P<\/jats:italic> < 0.001), and fatigue (28.3% versus 37.0%; P<\/jats:italic> = 0.024). Anti\u2013double\u2010stranded DNA<\/jats:styled-content>, anti\u2013\u03b22<\/jats:sub>\u2010glycoprotein I antibodies, positive Coombs\u2019 test results, autoimmune hemolytic anemia, hypocomplementemia, and leukopenia were more common in early SLE<\/jats:styled-content> than in SLE<\/jats:styled-content>\u2010mimicking conditions. Symptoms detailed in the ACR<\/jats:styled-content> and SLICC<\/jats:styled-content> classification criteria were significantly more frequent among those with early SLE<\/jats:styled-content>. Fewer patients with early SLE<\/jats:styled-content> were not identified as having early SLE<\/jats:styled-content> with use of the SLICC<\/jats:styled-content> criteria compared to the ACR<\/jats:styled-content> criteria (16.5% versus 33.9%), but the ACR<\/jats:styled-content> criteria demonstrated higher specificity than the SLICC<\/jats:styled-content> criteria (91.6% versus 82.4%).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In this multicenter cohort, clinical manifestations that could help to distinguish early SLE<\/jats:styled-content> from SLE<\/jats:styled-content>\u2010mimicking conditions were identified. These findings may aid in earlier SLE<\/jats:styled-content> diagnosis and provide information for ongoing initiatives to revise SLE<\/jats:styled-content> classification criteria.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40674","type":"journal-article","created":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T07:40:59Z","timestamp":1532331659000},"page":"91-98","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":112,"title":["How Do Patients With Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria"],"prefix":"10.1002","volume":"71","author":[{"given":"Marta","family":"Mosca","sequence":"first","affiliation":[{"name":"University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen H.","family":"Costenbader","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindhu R.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Lorenzoni","sequence":"additional","affiliation":[{"name":"Scuola Superiore Sant\u2019Anna Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2969-6649","authenticated-orcid":false,"given":"Gian Domenico","family":"Sebastiani","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera San Camillo\u2010Forlanini Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bimba F.","family":"Hoyer","sequence":"additional","affiliation":[{"name":"Christian\u2010Albrechts\u2010University and University Hospital Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Navarra","sequence":"additional","affiliation":[{"name":"University of Santo Tomas Manila Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0520-4681","authenticated-orcid":false,"given":"Eloisa","family":"Bonfa","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas HCFMUSP Faculdade de Medicina da 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