Raynaud's phenomenon and positive antinuclear antibodies in a malignancy.

Abstract

Both Raynaud's phenomenon and the presence of antinuclear antibodies are uncommon features of malignant disease and the association of both with a malignancy extremely rare. The case is reported of a 78 year old woman who presented with Raynaud's phenomenon and positive antinuclear antibodies related to adenocarcinoma of unknown primary site.Raynaud's phenomenon is a vascular disorder characterised by episodes of abnormal digital vasospasm in the hands and sometimes in the feet. These episodes occur in response to cold or emotional stress and produce one or more colour changes. The most common sequence is an initial pallor followed by cyanosis and rubor, but incomplete episodes are more common.' The prevalence in the general population has been estimated as 4-10%.2 Raynaud's phenomenon as an isolated condition is classified as primary, and secondary when an underlying cause can be identified.' The presence of antinuclear antibodies in these patients was often associated with connective tissue diseases3 and only in rare cases with malignancies.4 We report a patient with Raynaud's phenomenon and a high antinuclear antibody titre related to neoplasia.

Digital Necrosis and Lupus-Like Syndrome Preceeding Ovarian Carcinoma

“…Immunologic cross-reactivity to tumoral antigen could explain the lupus-like syndrome previously reported [3, 7, 11, 12] as in our observation. In addition, the immune dysregulation may result in antigen/antibody complexes targeted to the vascular endothelium as in paraneoplastic nephrotic syndrome [2, 3, 11].…”

“…Most of them involved women over 50 years old [7]. Digital ischemia is usually bilateral, and sometimes presents as Raynaud’s phenomenon, but rapidly evolves to necrosis [8, 9].…”

Paraneoplastic Raynaud's phenomenon manifesting before the diagnosis of lung cancer

“…Often, these symptoms can be precipitated or aggravated by exposure to cold, emotional stress or vibrations. A typical episode of this vasogenic phenomenon encompasses a sequence of initial pallor, subsequent cyanosis followed by rubor and dolor (redness and pain) 2–4…”

Hypertrophic Pulmonary Osteoarthropathy with Positive Antinuclear Antibodies: Case Report

“…The significance of antinuclear antibodies in malignancies is not well understood according to Zuber [ 6 ]. The antigens may be specific to each type of tumor and the production of antibodies would be an attempt to neutralize them.…”