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AB0114 Raynaud's phenomenon: correlation between clinical manifestations and nailfold capillary microscopy
  1. B Rodríguez-Lozano,
  2. A Alvarez,
  3. J Bethencourt,
  4. A Arteaga,
  5. M Gantes,
  6. E Trujillo,
  7. T González
  1. Rheumatology, Hospital Universitario de Canarias, La Laguna, Spain

Abstract

Objectives To determine the correlations between clinical characteristics and nailfold capillary patterns in patients with Raynaud's phenomenon (RP).

Methods Analysis of clinical and immunological features (RP: phases; time duration in years, symmetry, localization; skin and organ involvement, ANA tests) and nailfold capillary patterns were assessed in 150 patients referred for evaluation of RP during the period 1999–2000. Chi-Square and Fisher´s tests were used for statistical analysis.

Results 142/8 female/male; mean age:42+ 15,6 years; RP duration:5,7 years. 47% of RP were referred without diagnosis, 5,5% as primary RP (pRP) and 49% as secondary RP (sRP): connective tissue diseases (CTD) in 73% of cases. Microangiopathic patterns detected were:38% normal, 25% functional (capillary pallor/hyperemia); 20% CTD pattern without specific capillary abnormalities of scleroderma (SSc), and 17% with SSc-pattern (?slow pattern? 7,6%; ?active pattern? 9,7%). Patients with slow pattern SSc were older than the patients with other patterns: mean average:53,8 years (p < 0,05). RP with uniphasic colour changes were observed principally in patients with normal o functional pattern and RP with biphasic colour changes in patients with SSc-pattern (p < 0,02). Significant association between ?slow? pattern SSc and anticentromere antibodies was detected (p < 0,004) and between ?active? pattern SSc and positive ANA test with nucleolar pattern. Anticentromere antibodies were detected in 9% of patients showing functional pattern with capillary pallor and ?active? pattern SSc was observed in 42% of positive Scl-70 antibodies patients. Sclerodermatous skin changes was associated with SSc-pattern and functional capillary pallor pattern (p < 0,001) and a higher proportion of soft tissue swelling in hands and organ involvement was detected in patients with ?slow? pattern-SSc.

Conclusion Functional pattern with capillary pallor showed a significant association with uniphasic RP, sclerodermatous skin changes and negative ANA test. Only 42% of patients with positive Scl-70 antibodies exhibited ?active? pattern.

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