Document Detail

Transition from primary Raynaud's phenomenon to secondary Raynaud's phenomenon identified by diagnosis of an associated disease: results of ten years of prospective surveillance.
MedLine Citation:
PMID:  16732585     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the early signs, risk factors, and rate of transition from primary Raynaud's phenomenon (primary RP) to secondary RP. METHODS: A clinical sample of 307 consecutive patients with RP was included in a prospective followup study. After an initial screening, 244 patients were classified as having primary RP, of whom 236 were followed up for a mean +/- SD of 11.2 +/- 3.9 years. Patients classified according to the screening as having suspected secondary RP underwent an extended screening program annually until transition to secondary RP occurred. RESULTS: The initial prevalence of secondary RP was 11%. The annual incidence of transition to suspected secondary RP was 2%, and the annual incidence of transition to secondary RP was 1%. Overall, 46 patients were classified as having suspected secondary RP, and 23 of these later were classified as having secondary RP. Older age at onset of RP (hazard ratio 2.59, 95% confidence interval [95% CI] 1.40-4.80), shorter duration of RP at enrollment (hazard ratio 0.87, 95% CI 0.81-0.94), and abnormal findings on thoracic outlet test (hazard ratio 2.69, 95% CI 1.12-6.48) were associated with an increased risk for transition to secondary RP. Compared with patients with suspected secondary RP, those diagnosed as having secondary RP had a higher number and earlier occurrence of pathologic findings. Furthermore, antinuclear antibodies at a titer of > or = 1:320 and positive findings in specific serologic subsets were associated with a significantly increased risk for developing a connective tissue disease. CONCLUSION: Patients diagnosed initially as having primary RP may actually comprise 1 of 3 groups: those with idiopathic RP, those with a rather benign disease course, and those with a more severe course of the disease.
Mirko Hirschl; Katharina Hirschl; Matthias Lenz; Reinhold Katzenschlager; Hans-Peter Hutter; Michael Kundi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  54     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-19     Completed Date:  2006-07-14     Revised Date:  2008-01-18    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1974-81     Citation Subset:  AIM; IM    
Hanuschkrankenhaus, Vienna, Austria.
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MeSH Terms
Antibodies, Antinuclear / blood
Follow-Up Studies
Middle Aged
Prospective Studies
Raynaud Disease / classification,  diagnosis*,  immunology,  pathology
Reg. No./Substance:
0/Antibodies, Antinuclear
Comment In:
Arthritis Rheum. 2007 Jun;56(6):2102-3; author reply 2103-4   [PMID:  17530659 ]
Perspect Vasc Surg Endovasc Ther. 2007 Sep;19(3):341-2   [PMID:  17911571 ]

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