A survey on practice of vasculitis syndrome in rural area of Japan

Abstract

［Objective］Vasculitis syndrome includes several symptoms, and delays in diagnosis adversely influence the prognosis of affected organs and overall survival. We investigated the treatment of vasculitis syndrome in rural Japan. ［Methods］We distributed a questionnaire on vasculitis syndrome intended for doctors of internal medicine, orthopedic surgery, and dermatology from November 2017 to December 2017. ［Results］Of the 206 practitioners and 40 hospital physicians, 98 and 25 responded to the questionnaire（response rate of 47.6% and 62.5%, respectively）. Although the clinical practice guideline for the management of antineutrophil cytoplasmic antibody（ANCA）-associated vasculitis was the most recognized, recognition of the guideline by practitioners was low. Renal dysfunction, proteinuria, and hematuria were considered signs of renal vasculitis, but the most common time of referral to a specialist was when renal dysfunction had already progressed. ［Conclusions］The recognition of vasculitis guidelines by rural Japanese physicians is inadequate, and patients with vasculitis are referred to a specialist after organ involvement.