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Severity of seropositive isolated Raynaud's phenomenon is associated with serological profile
1First Department of Internal Medicine, Yokohama City, University of Medicine, Yokohama City, Japan. ihata@pp.iij4u.or.jp
Objective:
To examine the relationship between the clinical severity of seropositive isolated Raynaud's phenomenon (RP) and its serological background by analyzing digital blood flow data obtained by laser Doppler flowmetry (LDF).
Methods:
We analyzed digital blood flow by LDF in 13 healthy volunteers, 55 patients with seropositive isolated RP, and 13 patients with anti-Scl-70 antibody positive systemic sclerosis (SCL). The serological profiles of patients with RP were as follows: 30 patients had the anti-centromere antibody (C) and 19 the anti-RNP antibody (RNP). We designated the RP in each patient group as C-RP, RNP-RP, and SCL-RP. We used an "arm-raising test" by which blood pressure could be passively depressed, and the cold provocation test, which induced vasoconstriction through the sympathetic reflex. We defined 2 variables, the recovery velocity after cold exposure (RV-CE) and the increase in the amplitude of the digital pulse wave during the arm-raising test (IA-AR), that are the most reliable and sensitive variables indicating the severity of RP.
Results:
Both RV-CE and IA-AR correlated significantly with the clinical severity of RP. In IA-AR and RV-CE, there was a significant difference between C-RP and RNP-RP (IA-AR 107.1 +/- 25.63 vs 37.4 +/- 17.25%; RV-CE 0.0667 +/- 0.010 vs 0.035 +/- 0.0096 V/s), showing that C-RP tended to be less severe than RNP-RP.
Conclusion:
We defined 2 variables that correlated with the clinical severity of RP; using them we found that anti-centromere antibody positive RP is less severe than RNP-RP