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Raynaud's phenomenon.

Michael Hughes1, Ariane L Herrick2

  • 1Centre for Musculoskeletal Research, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Best Practice & Research. Clinical Rheumatology
|July 17, 2016
PubMed
Summary
This summary is machine-generated.

Raynaud's phenomenon (RP) in autoimmune diseases like systemic sclerosis (SSc) requires careful assessment. Early diagnosis using nailfold capillaroscopy and autoantibodies aids in predicting complications and guiding treatment for better patient outcomes.

Keywords:
Connective tissue diseaseDigital ischaemiaRaynaud's phenomenonSclerodermaSystemic sclerosisTreatment

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Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Immunology

Background:

  • Raynaud's phenomenon (RP) is a significant cause of morbidity in autoimmune connective tissue diseases (CTDs), especially systemic sclerosis (SSc).
  • Differentiating primary RP from secondary RP, particularly that associated with CTDs, is crucial for prognosis and management.
  • Autoimmune CTDs significantly impact patient quality of life, necessitating effective diagnostic and therapeutic strategies.

Purpose of the Study:

  • To outline the comprehensive clinical assessment required for patients presenting with RP.
  • To highlight key investigations, including nailfold capillaroscopy and autoantibody testing, for identifying CTD-associated RP.
  • To discuss the multifaceted management approaches and potential complications of CTD-associated RP.

Main Methods:

  • Clinical assessment to distinguish primary from secondary RP.
  • Nailfold capillaroscopy to evaluate microvascular changes.
  • Serological testing for autoantibodies, particularly SSc-specific antibodies.
  • Review of current treatment modalities for CTD-associated RP.

Main Results:

  • Patients with RP and abnormal nailfold capillaroscopy or SSc-specific antibodies have a high risk of developing CTDs.
  • Nailfold capillaroscopy and autoantibody profiles can predict organ-specific complications.
  • CTD-associated RP management involves conservative measures, pharmacotherapy (e.g., calcium channel blockers, PDE5 inhibitors), and advanced treatments for severe cases.

Conclusions:

  • Early identification of CTD-associated RP through specific investigations is vital for risk stratification and complication prediction.
  • A multimodal treatment strategy, tailored to disease severity, is essential for managing CTD-associated RP.
  • Further research into RP pathogenesis and targeted therapies is needed to improve outcomes and minimize side effects.