Centre for Rheumatology, Royal Free Hospital and UCL Medical School, London, UK.
Clin Rev Allergy Immunol. 2012 Dec;43(3):249-55. doi: 10.1007/s12016-012-8331-1.
Raynaud's phenomenon often precedes the diagnosis of systemic sclerosis and is the first symptom of the disease in many cases. Antinuclear antibody positivity can assist in the early identification of cases of isolated Raynaud's phenomenon likely to progress to systemic sclerosis. However, the specific differences between rate of progression for different scleroderma hallmark antibodies is less clear. We review the predictive potential of ANA positivity and nailfold capillaroscopy for identifying cases of Raynaud's phenomenon which may progress to connective tissue diseases. We also have reviewed data from our own large scleroderma cohort to explore the relationship between antibody subtype and time to development of SSc. Duration of pre-existing Raynaud's phenomenon may be an important determinant of the profile of systemic sclerosis cases identified through screening. Ninety-five percent of our patients with isolated Raynaud's phenomenon, negative autoimmune serology on more than one visit and normal capillaroscopy score showed no progression to connective tissue disease. Duration of antecedent Raynaud's phenomenon differs between disease subsets and scleroderma-specific ANA patterns.
雷诺现象常先于系统性硬化症的诊断，且在许多情况下是该病的首发症状。抗核抗体阳性有助于早期识别可能进展为系统性硬化症的孤立性雷诺现象病例。然而，不同硬皮病标志性抗体的进展速度之间的具体差异尚不清楚。我们回顾了 ANA 阳性和甲襞毛细血管镜检查对识别可能进展为结缔组织疾病的雷诺现象病例的预测潜力。我们还回顾了来自我们自己的大型硬皮病队列的数据，以探讨抗体亚型与发生 SSc 的时间之间的关系。预先存在的雷诺现象的持续时间可能是通过筛查确定的系统性硬化症病例特征的一个重要决定因素。在我们的孤立性雷诺现象患者中，95%的患者在多次就诊时自身免疫血清学检查均为阴性，且毛细血管镜评分正常，没有进展为结缔组织疾病。疾病亚组和特异性抗核抗体模式之间的先前存在的雷诺现象的持续时间不同。
