Digital pressure responses to cooling in patients with suspected early vs definite scleroderma (systemic sclerosis) vs primary Raynaud's phenomenon.

OBJECTIVE: To compare digital vascular responses to local finger cooling in 4 groups of subjects: patients with definite scleroderma (SD, systemic sclerosis) meeting ARA criteria (n = 16), patients with suspected early SD (n = 12), patients with primary Raynaud's phenomenon (RP) (n = 23) and a control group of 29 healthy subjects. METHODS: Their digital systolic pressures were measured at 30, 20, 15 and 10 degrees C finger cuff temperature, in a room kept at 18 degrees C. RESULTS: The results of the digital pressure measurements showed a clearcut difference between the SD, primary RP and control groups, but there was no difference between patients with definite SD and those with suspected early SD. CONCLUSION: Under our experimental conditions, digital pressure response to local cooling separates groups of patients with primary RP and those with secondary RP related to SD from each other and from controls. The similarity between digital pressure responses of patients with suspected early SD and those with definite SD, suggests an early organic involvement of the digital vasculature in SD.

Demographic, social and clinical correlates of Raynaud phenomenon.

Our study has identified the demographic, social and clinical correlates of primary Raynaud phenomenon (RP) from a case-control study involving 235 subjects who were identified from a population-based prevalence survey of RP. All potential cases and a sampling of probable non-cases, identified by a screening questionnaire, were invited to a medical clinic for diagnostic testing and assignment of case or control status. Odds ratios (OR) for risk indicators for primary RP were estimated using multiple logistic regression to obtain 95% confidence intervals. The regression yielded statistically significant (p less than 0.05) positive associations for sex (OR = 3.0 for females versus males), self-reported alcohol use (OR = 1.1) and diastolic blood pressure (OR = 1.2) in those on antihypertensive medication. A significant (p = less than 0.01, OR = 0.4) negative association was found for Quetelet index (a measure of obesity). Near-significant or suggestive but non-significant negative associations were found between RP and marital status (p = 0.05, OR = 2.5), increased years of education and, for those on antihypertensive medication, higher systolic blood pressure (both p = 0.07).

Major clinical diagnoses found among patients with Raynaud phenomenon from the general population.

This study of 62 individuals with Raynaud phenomenon (RP) drawn from the general population of South Carolina shows a profile of associated diseases that is different from the one reported from hospital based studies. We found that connective tissue diseases affect a much smaller fraction of patients with RP than previously reported. Compared to RP negative controls, our RP positive group was found to suffer more frequently from a variety of diseases, both RP related and not RP related.

Prevalence of Raynaud phenomenon in the adult population of South Carolina.

A prevalence estimate for Raynaud phenomenon among adult residents of South Carolina was based on data obtained from respondents in a statewide health survey, followed by face-to-face interviews and clinical screening for Raynaud phenomenon, using a screening procedure developed by the authors. The survey obtained 5246 personal interviews from a probability sample of over 3000 households, and 494 survey subjects participated in the clinical screening. The prevalence estimates and their standard errors were computed using survey case weights, design-based estimation, and logistic modelling techniques. The prevalence of Raynaud phenomenon among adult residents of South Carolina was determined to be 3.5%, with a standard error of 0.6%. Prevalence was higher for females (4.3%, SE = 0.7%) than for males (2.7%, SE = 0.6%). These figures are much lower than most estimates in the existing literature on Raynaud phenomenon.

Prevalence of scleroderma spectrum disorders in the general population of South Carolina.

The prevalence of scleroderma spectrum disorders (including systemic sclerosis [SSc] meeting the American Rheumatism Association criteria and the less typical disorders meeting only our study criteria) was determined in a random sample of 6,998 subjects from the general population of South Carolina. The results suggest that the prevalence of these disorders may range from 67 to 265 per 100,000, which is 4.9 to 19.2 times higher than previously reported for definite SSc. The ratio of nondefinite cases to definite cases of SSc (those meeting American Rheumatism Association criteria) was 2.5. Most of the nondefinite cases were unrecognized prior to our study, which suggests the need for improved early diagnosis of scleroderma spectrum disorders. Brief histories of the 7 patients with scleroderma spectrum disorders whose cases formed the basis for our calculation of prevalence rates are included in this report.