Development of connective tissue disease in patients presenting with Raynaud's phenomenon: a six year follow up with emphasis on the predictive value of antinuclear antibodies as detected by immunoblotting.

Kallenberg, Cees G. M.; Wouda, A. A.; Hoet, M. H.; Venrooij, Walther J. van

doi:10.1136/ard.47.8.634

Cited by 162 publications

(66 citation statements)

References 21 publications

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“…The only significant association with clinical variables was seen in non-GI symptoms (i.e., respiratory involvement) ( Table 2). Once again, the strong association (specificity of 100%) (38) between Scl-70 positivity and scleroderma was confirmed, as well as the fact that a brief duration of Raynaud's phenomenon before the development of skin changes is typical whereas patients with the limited cutaneous type of the disease have a significantly longer duration of Raynaud's phenomenon before overt skin and visceral involvement occur (8). Therefore, the presence of Raynaud's phenomenon per se is not predictive of abnormal esophageal function, but rather shows an association with existing scleroderma (39).…”

Section: Discussionmentioning

confidence: 95%

Esophageal dysfunction in scleroderma. Relationship with disease subsets

Bassotti

Battaglia

Debernardi

et al. 1997

Arthritis & Rheumatism

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Objective. To investigate the relationship between esophageal function and the extent of disease in a nonselected group of scleroderma patients, and to study gastric and small bowel motility in a group of scleroderma patients with more severe clinical manifestations.Methods. Esophageal function in 125 scleroderma patients was investigated by radiologic, endoscopic, manometric, and pH-metric techniques. Ten patients also underwent gastrointestinal (GI) manometric recording, both during fasting and after a standard meal.Results. Radiologic abnormalities of the esophagus were found in 55 of 81 patients (68%) and esophagitis in 45 of 125 (36%). No significant relationship was disclosed between GI symptoms, radiologic abnormalities, esophagitis grade, and the various disease subsets. However, the overall incidence of endoscopic esophagitis (irrespective of the degree) was significantly (P < 0.05) correlated with the patient subgroups, with 100% incidence of esophagitis in those having the more severe cutaneous involvement (type 111). Manometric abnormalities were documented in 80% of patients, and pathologic reflux in 78%. The severity of esophageal abnormalities on manometry significantly correlated with the severity of the disease, whereas no correlations were found with pH-metric data. Ninety percent of the . ~~~~~

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Section: Discussionmentioning

confidence: 95%

Esophageal dysfunction in scleroderma. Relationship with disease subsets

Bassotti

Battaglia

Debernardi

et al. 1997

Arthritis & Rheumatism

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“…Other autoantibodies are also helpful. The anticentromere antibody is associated with limited cutaneous disease (sensitivity 60%, specificity 98%) and the anti-Scl-70 antibody is associated with diffuse cutaneous disease (sensitivity 38%, specificity 100%) (35).…”

Section: The Esophagusmentioning

confidence: 99%

Gastrointestinal motility disorders in scleroderma

Sjogren

1994

Arthritis & Rheumatism

339

228

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“…Occurring in more than 90% of patients, RP often precedes skin and visceral fibrosis by years or decades (2). Hence, at initial presentation of RP, there is a need for novel predictors to help physicians in identifying the patients who are at risk of developing SSc or another connective tissue disease (CTD) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

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confidence: 99%

Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud's phenomenon to systemic sclerosis: A twenty‐year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis

Koenig

Fritzler

Roussin

et al. 2008

Arthritis & Rheumatism

537

371

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Objective. To identify in patients with Raynaud's phenomenon (RP) independent markers that predict progression to definite systemic sclerosis (SSc) and to determine in patients with progression to SSc the type and sequence of microvascular damage and its relationship to SSc-specific autoantibodies.Methods. Consecutive patients referred for evaluation of RP who had no definite connective tissue disease were evaluated for microvascular damage by nailfold capillary microscopy (NCM) and for anticentromere (anti-CENP-B), anti-Th/To, anti-topoisomerase I, and anti-RNA polymerase III (anti-RNAP III) autoantibodies by specific assays. Patients were studied prospectively.Results. Of the 586 patients who were followed up for 3,197 person-years, 74 (12.6%) developed definite SSc. A characteristic sequence of microvascular damage was identified, starting with enlarged capillaries, followed by capillary loss, and then by capillary telangiectases. Definite SSc was diagnosed in close temporal relationship to capillary loss. Enlarged capillaries, capillary loss, and SSc-specific autoantibodies independently predicted definite SSc. Anti-CENP-B and antiTh/To antibodies predicted enlarged capillaries; these autoantibodies and anti-RNAP III predicted capillary loss. Each autoantibody was associated with a distinct time course of microvascular damage. At followup, 79.5% of patients with 1 of these autoantibodies and abnormal findings on NCM at baseline had developed definite SSc. Patients with both baseline predictors were 60 times more likely to develop definite SSc. The data validated the proposed criteria for early SSc.Conclusion. In RP evolving to definite SSc, microvascular damage is dynamic and sequential, while SScspecific autoantibodies are associated with the course and type of capillary abnormalities. Abnormal findings on NCM at baseline together with an SSc-specific autoantibody indicate a very high probability of devel-

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Development of connective tissue disease in patients presenting with Raynaud's phenomenon: a six year follow up with emphasis on the predictive value of antinuclear antibodies as detected by immunoblotting.

Cited by 162 publications

References 21 publications

Esophageal dysfunction in scleroderma. Relationship with disease subsets

Esophageal dysfunction in scleroderma. Relationship with disease subsets

Gastrointestinal motility disorders in scleroderma

Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud's phenomenon to systemic sclerosis: A twenty‐year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosis

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