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Raynaud's phenomenon (RP) can be the first manifestation or may be present before the development of an overt systemic sclerosis (SSc).1
Enhanced liver fibrosis (ELF) test, an algorithm combining tissue inhibitors of matrix metalloproteinases (TIMP-1), hyaluronic acid (HA) and aminoterminal propeptide of type III procollagen (PIIINP), has been related to several measures of fibrosis in SSc patients.2–4
We evaluated whether these biomarkers could discriminate between primary and secondary RP.
Consecutive adult patients with RP at the first rheumatologic evaluation were recruited from February 2011 to May 2012 with ethics committee approval. Exclusion criteria were history of any fibrosing disorder, organ transplantation, hepatocellular carcinoma or treatment with interferon. One patient was excluded for interferon treatment. Fifteen limited cutaneous SSc and 15 diffuse cutaneous (dc) …