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Fibrosis biomarkers in isolated Raynaud's phenomenon: too little, too soon?
  1. Francesca Ingegnoli1,
  2. Roberta Gualtierotti1,
  3. Tommaso Schioppo1,
  4. Annalisa Orenti2,
  5. Patrizia Boracchi2,
  6. Chiara Lubatti1,
  7. Claudio Mastaglio3,
  8. Valentina Galbiati3,
  9. Antonella Murgo1,
  10. Silvana Zeni1,
  11. Claudia Grossi4,
  12. Orietta Borghi4,
  13. William Rosenberg5,
  14. Laura Castelnovo6,
  15. Luigi Meroni Pier1,4
  1. 1 Department of Clinical Science & Community Health, Division of Rheumatology, Istituto Gaetano Pini, University of Milano, Milano, Italy
  2. 2 Department of Clinical Science & Community Health, Medical Statistics and Biometry, University of Milano, Milano, Italy
  3. 3 Rheumatology Unit, Ospedale Moriggia-Pelascini, Gravedona, Italy
  4. 4 Research Laboratory on Immuno-Rheumatology, IRCCS Istituto Auxologico Italiano, Milano, Italy
  5. 5 Division of Medicine, Institute for Liver and Digestive Health, University College London, Royal Free Campus, London, UK
  6. 6 Dipartimento Medico, U.O.C. Medicina Interna, Presidio Ospedaliero di Saronno, Saronno, Italy
  1. Correspondence to Dr Ingegnoli Francesca, Department of Clinical Science & Community Health, Division of Rheumatology, Istituto Gaetano Pini, University of Milano, Piazza Cardinal Ferrari 1, Milano 20122, Italy; francesca.ingegnoli{at}

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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.24

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 …

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  • Contributors IF, GR and ST: study design, patient recruitment and drafting the article; OA and BP: statistical analysis; LC, MC, GV, MA, ZS and CL: patient recruitment; GC, BO and RW: lab analysis; MPL: study design and revising the article.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Hospital ethical committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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