Sjögren's Diagnosis Delays in Women Expose Persistent Autoimmune Recognition Gaps

Inaba described initial dismissal by her ophthalmologist despite reporting corneal damage, dry mouth, fatigue, and brain fog. This pattern matches findings from a 2019 Rheumatology International analysis of 1,000 Sjögren's patients showing median diagnosis time of 4.1 years for women versus 2.8 for men, driven by symptom overlap with menopause and fibromyalgia. Systemic under-recognition persists because primary care and ophthalmology training allocates minimal time to sicca symptoms outside classic presentations. A 2022 Lancet Rheumatology review of 12 cohorts confirmed that 62% of female patients received at least three prior misdiagnoses, including depression or chronic fatigue, before rheumatology referral. These delays compound organ damage risk and mental health burden without triggering policy responses equivalent to other chronic conditions.