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Influence of comorbidities and patient demographics on Raynaud's symptom characteristics: implications for diagnosis
Reshma Seomore1, Matthew Wells1,2, Ula Tymoszuk3
1Department of Rheumatology, North Bristol NHS Trust, Bristol, UK.
Objectives:
Associations between Raynaud's phenomenon (RP) and body mass index (BMI), fibromyalgia syndrome (FMS) and migraine have been reported but their influence on the lived experience of RP is unknown.
Design:
Cross-sectional electronic survey.
Setting:
A social media-based awareness campaign organised by Scleroderma & Raynaud's UK.
Participants:
4141 respondents with RP, including 3279 with primary RP (PRP), 476 with systemic sclerosis-related RP (SSc-RP) and 386 with other systemic autoimmune rheumatic disease-related RP (SARD-RP).
Interventions:
Not applicable.
Main Outcome Measures:
RP symptom characteristics (colour change patterns, pain, numbness, tingling and thumb involvement) and their associations with BMI, FMS and migraine.
Results:
In PRP, low BMI correlated with higher prevalence of cyanosis (55.1% vs 41.2%), hyperaemia (48.2% vs 41.3%), triphasic change (30.4% vs 23.0%) and thumb involvement (36.0% vs 27.0%) compared with high BMI. In PRP, concomitant FMS was associated with higher prevalence of pain (77.7% vs 57.4%), cyanosis (53.8% vs 45.4%), tingling (72.6% vs 62.8%) and thumb involvement (46.2% vs 27.2%) compared with those without FMS. Higher prevalence of pain was reported by FMS respondents with SSc-RP (82.8% vs 69.9%) and SARD-RP (84.1% and 70.9%, respectively). In PRP, migraine was associated with higher prevalence of cyanosis (50.0% vs 44.9%), hyperaemia (50.3% vs 43.7%), pain (69.0% vs 56.2%) and thumb involvement (33.4% vs 27.1%). Migraine was associated with higher prevalence of hyperaemia and pain in SARD-RP.
Conclusion:
BMI, FMS and migraine influence the lived experience of RP, particularly in PRP. FMS is associated with a greater pain burden, whereas low BMI and migraine are associated with prominent vasospastic features. These aetiopathogenic drivers influence RP symptomatology, with implications for management.
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