Evidence map›Paper›PMID 41917539›Full record

ArticleClinical rheumatology2026

The diagnostic pathway and time to diagnosis in ANCA-associated vasculitis: a retrospective study at a tertiary rheumatology center.

Pauline Bussmann, Uta Kiltz, Hilal Kavruk, Philipp Sewerin, Johanna Mucke, Diana Vossen, David Kiefer, Ioana Andreica, Johanna Heuser, Judith Erkenberg and 4 more

Abstract read
In one paragraph

Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Pauline BussmannRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Uta KiltzRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Hilal KavrukRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Philipp SewerinRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Johanna MuckeRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Diana VossenRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
David KieferRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Ioana AndreicaRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Johanna HeuserRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Judith ErkenbergRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Panagiotis ErmeidisRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Ralph BrinksRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Xenofon BaraliakosRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany.
Anna KernderRuhr Universität Bochum, Rheumazentrum Ruhrgebiet, Rheumatology, Herne, Germany. anna.kernder@elisabethgruppe.de.ORCID http://orcid.org/0000-0002-7742-7526

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo analyze the diagnostic pathway of patients with ANCA-associated vasculitis (AAV) and to identify factors associated with the time to diagnosis, including the role of referring and previously consulted medical specialties.

methodsThis retrospective single-center study analyzed patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA) who received their diagnosis between 2014 and 2024. Data were extracted from medical records. Time to diagnosis was defined as the period between first AAV-related symptoms and confirmed diagnosis. Factors associated with diagnostic delay were analyzed using multivariate Cox regression. Temporal differences between subtypes were visualized using Kaplan-Meier curves.

resultsA total of 216 patients were included (GPA n = 128; MPA n = 70; EGPA n = 18). Median time to diagnosis was numerically longest in EGPA (455 days [IQR 144-924]) compared with GPA (120 days [IQR 61334]) and MPA (153 days [IQR 90-366]). Renal involvement was statistically associated with a shorter time to diagnosis (HR 1.65, 95% CI 1.18-2.31, p = 0.004), whereas prior consultations with dermatologists (HR 0.41, p = 0.004), pulmonologists (HR 0.58, p = 0.003), and rheumatologists (HR 0.63, p = 0.003) showed longer delays. Higher BVAS and CRP levels statistically correlated with shorter diagnostic intervals.

conclusionThe diagnostic delay in AAV varies by disease subtype and clinical presentation. EGPA shows the numerically longest time to diagnosis, while renal involvement seems to facilitate earlier diagnosis. Enhanced awareness among non is essential to reduce diagnostic delay and prevent organ damage, although outcome measures were not assessed in our study. Key Points • Diagnostic delay in ANCA-associated vasculitis varies between disease subtypes, organ involvement, and consulted specialties. • EGPA shows the numerically longest diagnostic delay, whereas renal involvement seems to facilitate earlier diagnosis. • Earlier recognition of AAV across specialties may reduce diagnostic delay and prevent organ damage.

Indexed as

Anti-Neutrophil Cytoplasmic Antibody-Associated VasculitisChurg-Strauss SyndromeDelayed DiagnosisMicroscopic PolyangiitisAgedFemaleGranulomatosis with PolyangiitisHumansMaleMiddle AgedReferral and ConsultationRetrospective StudiesRheumatologyTertiary Care CentersTime FactorsTreatment DelayAnti-neutrophil cytoplasmic antibody-associated vasculitisDelayed diagnosisReferral and consultation

Identifiers

PMID41917539
PMCPMC13249735

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.