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.]

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Hungarian Immunology

[Undifferentiated connective tissue disease]

BODOLAY Edit, SZEGEDI Gyula

[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.]

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

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[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.]

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[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.]

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