Clinical diagnosis found in patients with Raynaud’s phenomenon: a multicentre study

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A multicentre observational study was conducted in order to detect
the major clinical diagnosis found in 761 patients with
Raynaud's phenomenon (RP) attending 50 Italian centres for
rheumatology and internal medicine. Systemic sclerosis was the
most frequent condition associated with secondary RP,
occurring in 216 (28.4%) patients. The other most frequent
clinical diagnoses included systemic lupus erythematosus (52
cases: 6.8%) and rheumatoid arthritis (38 cases: 5%). Other
RP-related diseases (hypertension, Sjogren's syndrome, mixed
connective tissue disease, undifferentiated connective tissue
disease, fibromyalgia, carpal tunnel syndrome,
cryoglobulinemia, dermatopolymyositis, vasculitis, thoracic
outlet syndrome, hypothyroidism, diabetes mellitus) occurred
in less than 5% of cases. A total of 130 (48%) out of 268
patients with primary RP showed one or more clinical features
indicating a fairly high risk of evolving into fully
established systemic sclerosis. None of these patients
ful-filled the ACR criteria for systemic sclerosis. This study
shows that over 50% of patients with RP attending 50 Italian
centres for rheumatology and internal medicine had a
connective tissue disease. The large number of patients with
primary RP and isolated clinical features of connective tissue
disease indicates that more efforts should be focused on
developing new criteria for the classification of RP.

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