Hungarian Immunology

[Importance of Raynaud’s phenomenon in the connective tissue diseases]

CZIRJÁK László, NAGY Zoltán

JANUARY 20, 2003

Hungarian Immunology - 2003;2(01)

[In the presence of Raynaud’s phenomenon compression syndromes, vibration, disorders causing hyperviscosity or arterial lesion and drog induced vasospasm should be excluded. In the background of unilateral Raynaud’s phenomenon organic, morphological abnormalities are present. Raynaud's phenomenon may also be the first symptom of connective tissue diseases, therefore the follow up of these cases is required. In case of patients with primary Raynaud’s phenomenon, the probability of developing a connective tissue diseases is very low. In the presence of antinuclear antibody positivity and/or scleroderma capillary pattern by capillarmicroscopy, the follow up is important, because these cases may develop a connective tissue disease, which predominantly belong to the scleroderma family. Simultaneous presence of Raynaud’s phenomenon and inflammation also strongly indicates that a connective tissue disease may later develop.]



Further articles in this publication

Hungarian Immunology

[Hand perfusion scintigraphy in primary and secondary Raynaud's syndrome]

GARAI Ildikó, GALUSKA László, VARGA József, SZŰCS Gabriella, CSIKI Zoltán

[INTRODUCTION - The aim of the study was to investigate the circulatory characteristics of primary and secondary Raynaud’s syndrome patients using the hand perfusion scintigraphic method developed by the Nuclear Medicine Department of the DUMHC. PATIENTS AND METHODS - The authors examined 84 patients presenting classical symptoms of the disease: episodic ischemia with three-phase color change of the fingers. After visual evaluation theyanalyzed the obtained images quantitatively, using of the finger/palm ratio. Statistical analysis comparisons were made between the clinically separated primary and the secondary Raynaud's group. RESULTS - With the visual evaluation regional perfusion disturbances were frequently found in the secondary group - 37 from 51 patients - while only 2 from 33 patients in the primery group; the difference was statistically significant (p<0,001). The results of the quantitative analysis showed that the finger/palm ratio (FPR) values were significantly lower (p<0.05) in primary Raynaud’s group. In the FPR values there were not any differences between genders or the fingers of the right and left hands. CONCLUSIONS - The hand perfusion scintigraphy applying Tc-99m-DTPA is a noninvasive, cost effective diagnostic tool, which reflects objectively the global and regional microcirculatory abnormalities of the hands, and offers quantitative data for the follow-up.]

Hungarian Immunology

[Undifferentiated connective tissue disease]


[Undifferentiated connective tissue disease (UCTD) is a term used by many authors to define a group a diffuse connective tissue disorders that lack definitive characteristics of any particular well-defined disorder. UCTD was diagnosed if the patients had at least two clinical symptoms and their sera contained one type of the anti nuclear antibody. Six hundred and sixty five patients with UCTD were followed between 1994 and 1999. The presence of the fever and anti-DNS antibodies correlated with SLE, arthritis/arthralgia and anti-RNP antibodies with MCTD, Raynaud phenomenon and ANA positivity with scleroderma, xerostomia/xerophtalmia and anti-SSA/SSB antibodies with Sjögren' syndromes, rheumatoid factor positivity and polyarthritis with rheumatoid arthritis. In conclusion, the UCTD represents a dynamic phase, one part of the patients show progression to definite connective tissue diseases, one part show regression, and on part of the patients stay in UCTD phase.]

Hungarian Immunology

[Early arthritis]


[Definitive autoimmune-inflammatory rheumatic diseases are often preceded by undifferentiated clinical syndromes including undifferentiated polyarthritis (UDP), undifferentiated connective tissue disease (UCTD) and early rheumatoid arthritis (RA). These are considered as distinct clinical entities. However, due to extensive overlapping patterns in clinical picture and treatment, these diseases may be commonly termed as ”early arthritis”. The optimal follow-up of such patients may only be carried out at specialized early arthritis clinics. Effective patient care should include the early use of prognostic indicators, as well as flexible pharmacological therapy.]

All articles in the issue

Related contents

Lege Artis Medicinae

[The up-to-date approach of Parkinson’s disease]


[Parkinson’s disease is the second most frequent neurodegenerative disease. Its aetiology has not been clarified yet, but genetical as well as environmental factors might have a significant role in its development. The differentiation between Parkinsonian syndromes and Parkinson’s disease (idiopathic Parkinsonian syndrome) could be very difficult even today. The accuracy of the diagnosis is no more than 90% despite the expertise of the best-trained neurologists and the use of the most sophisticated diagnostic procedures. A 100% of confidence can be achieved only by neuropathological examination. The precise recording of the anamnesis, the thorough knowledge of clinical symptoms and diagnostic tests could be helpful in establishing diagnosis as early and as accurately as possible, which might be crucial for choosing the most effective therapy. Nowadays we have a lot of pharmacotherapies and non-pharmacotherapies, the use of which can significantly increase the number of years with a good quality of life of patients with this currently untreatable condition.]

Lege Artis Medicinae



[INTRODUCTION - Rare asymptomatic pleuropulmonary neoplasms can represent serious differencial diagnostic difficulties both for clinicans and pathologists. Immunohistochemical tests are essential tools for the diagnosis of soliter fibrotic tumor of the pleura. These tests are also of diagnostic and prognostic importance. CASE REPORT - The report summarizes the case of an asymptomatic 63 years old man. The patient was admitted to hospital with a parahilar infiltrate of the right lung. Based on this chest X-ray abnormality pulmonary malignancy was suspected. The patient was referred to surgical intervention and the diagnosis of was based on post-surgical histology. These fibrotic tumors have typical immunohistochemical features. Although the histomorphology of the tumor suggested the presence of a benign tumor the p53 positivity and focal CD34 positivity indicated the possibility of malignant transformation as well. The patient is alive 17 months after surgery and there is no relapse of the disease. CONCLUSION - Although histologically benign, soliter fibrotic tumors of the pleura may occasionally transform into malignant variants. Therefore complete surgical resection and longterm clinical and close radiological follow-up is recommended for these patients. Clinician can plan well ahead the frequency and time of the follow-up with the help of the prognostic factors of hystology.]

Clinical Neuroscience

Health anxiety mediates the connection between somatosensory amplification and self-reported food sensitivity

ELIESON M. Linn, DÖMÖTÖR Zsuzsanna, KÖTELES Ferenc

Background - The frequency of self-reported food sensitivity (SFS) is increasing, and has a negative impact on the well-being and everyday functioning of the affected people. A considerable proportion of SFS cannot be medically explained. The lack of knowledge of its origin and treatment causes further stress in those affected. Purpose - This study aims to get a better understanding of the psychological background of the condition. Methods - A non-representative community sample (N=335; age: 35.1±13.18 yrs; 75.8% female) completed an English on-line questionnaire assessing somatosensory amplification, health anxiety, modern health worries (MHWs), beliefs concerning the scientific validity of complementary and alternative medicine (CAM), holistic beliefs on health and illness. Results - In multiple binary logistic regression analyses, SFS were associated with CAM related beliefs, somatosensory amplification, and health anxiety after controlling for age and gender. The connection between somatosensory amplification and SFS were completely mediated by health anxiety. No differences between the two groups were found with respect to MHWs, worries about the harmful effects of various artificial components in food, and holistic health beliefs. Discussion: More positive attitudes toward CAM might be based on the lack of conventional treatment, rather than on higher levels of MHWs or a more holistic worldview. Both the existence of symptoms and the presence of health anxiety might be needed for the development and maintenance of SFS. Conclusions - The findings support the notion that somatosensory amplification and health anxiety might play a role in the development and maintenance of SFS.

Hungarian Radiology

[Surgical treatment of scoliosis: pre- and postoperative follow-up with whole-body EOS radiography]


[Currently, Cotrel-Dubousset spondylodesis is the treatment of choice in orthopaedics. It allows for correction of deformity in three-dimensions allowing for stable fixation. EOS (Extended Orthopedic System) is an ultra low dose X-ray imaging system, simultaneously acquiring images of the whole body in two planes. Examinations with the EOS system is not only indicated in cases related to orthopaedics but in multiple other conditions owing to its low level of emitted radiation with rapid and cost-effective imaging. The importance of EOS examination is emphasized in systemic skeletal disorders, thus allowing itt o be used in various other clinical fields.]

Lege Artis Medicinae



[The authors provide a review on non-differentiated collagenosis (NDC) or, as it is called by another terminology, undifferentiated connective tissue disease (UCTD), outlining the clinical and serological alterations of the disease and give a definition of NDC. NDC is a pathological state when patients present clinical symptoms and serological alterations characteristic of a polysystemic autoimmune disease that cannot be explained by any other disease, where the symptoms however do not meet the diagnostic criteria of any other polysystemic autoimmune disease. NDC is a dynamic state and in 25-30% of the cases it may differentiate into CTD but in 40- 50% it remains in NDC stage and in 10-20% of the cases the patient may achieve remission. Differentiation is most frequent in the first two years of NDC. Patients should be treated and followed up in NDC state as well. The NDC stage is very important, since with the discovery of new autoantibodies, by employing new gene technology and by the follow-up and the treatment of the patients, our main aim is the earliest possible detection of differentiation into a definite polysystemic disease.]