In this case study, a 20-year-old Hispanic woman sought care during a routine wellness visit and reported intermittent joint pain and other subtle symptoms. Despite the absence of alarming clinical signs, a thorough review of her history and physical exam prompted further investigation. Lab work revealed thrombocytopenia, elevated ANA titers, and inflammatory markers, placing her at risk for systemic lupus erythematosus (SLE) per the EULAR/ACR classification. Early referral to rheumatology and hematology led to a diagnosis of SLE with immune thrombocytopenia and probable antiphospholipid syndrome. Prompt treatment with prednisone and hydroxychloroquine improved her symptoms and stabilized her platelet counts, with later initiation of anifrolumab infusions to further manage disease activity.
This case underscores the importance of early recognition and intervention in young patients with subtle or cyclical autoimmune symptoms. It highlights the need for healthcare providers—especially those in primary care or university health settings—to listen attentively, consider demographic risk factors, and provide clear guidance during care transitions. SLE diagnosis is often delayed due to symptom variability and a lack of cohesive diagnostic tools. Early detection, however, significantly improves outcomes and can help reduce disparities in disease burden among Hispanic women, who are at higher risk for early-onset and severe disease.
Reference: Campbell SL, Patel NK. Proactive identification of systemic lupus erythematosus: Detailed examination of early signs and symptoms for timely diagnosis. Nurse Pract. 2025 Feb 1;50(2):12-16. doi: 10.1097/01.NPR.0000000000000276. Epub 2025 Jan 23. PMID: 39844315; PMCID: PMC11756710.
