Article Text
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.