The effects of peripheral cold exposure on oesophageal motility in patients with autoimmune rheumatic diseases and raynaud's phenomenon

1991 ◽  
Vol 10 (3) ◽  
pp. 311-315 ◽  
Author(s):  
E. V. Tsianos ◽  
C. Berecos ◽  
E. Stavropoulos ◽  
E. Kazazis ◽  
I. C. Danielides ◽  
...  
2018 ◽  
Vol 16 (6) ◽  
pp. 178-184
Author(s):  
Z. R. Bagautdinova ◽  
◽  
I. R. Gaysin ◽  
L. V. Ivanova ◽  
A. A. Trukhina ◽  
...  

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1256.3-1257
Author(s):  
S. Lambova

Background:Videocapillaroscopy is the gold standard for evaluation of nailfold capillaries and the major tool used for differentiation of primary and secondary Raynaud’s phenomenon (RP) in rheumatology practice. However, nowadays, there are also accessible alternatives such as USB capillaroscopes, which offer the opportunity to apply capillaroscopic examination at a significantly lower price.Objectives:The aim of the current study was to study the utility of USB capillaroscope (Dinolite) via assessment of capillaroscopic images obtained by patients with primary and secondary RP in rheumatic diseases.Methods:The study represents analysis of capillaroscopic images of 32 patients with RP – primary and secondary in the context of SSc or other rheumatic diseases i.e., undifferentiated connective tissue disease (UCTD) and systemic lupus erythematosus (SLE). All the patients had signed an informed consent for participation in a study of their capillaroscopic, laboratory and clinical associations. The study represents retrospective analysis of the capillaroscopic images obtained from 8 fingers (II-V bilaterally) using USB capillaroscope (Dinolite) at magnification 200x. Capillary diameters were measured (arterial, venous and apical loop) as well as the number of capillaries per millimeter. The capillaroscopic images were categorized into the following groups i.e., I. Absence of microangiopathy: i) normal pattern, ii) nonspecific changes (dilated capillaries with arterial diameter > 0.015mm, venous > 0.020mm; haemorhhages and/or other nonspecific changes), II. Presence of microangiopathy i.e., “scleroderma”/”scleroderma-like” pattern. Presence of giant capillaries with capillary diameter >0.050mm was considered as a sufficient criterion for classifying the image as “scleroderma”/”scleroderma-like” pattern. For “scleroderma” type images in SSc patients staging of Cutolo et al (2000) was used i.e., “early”, ”active”, ”late” phase (1).Results:Images suitable for analysis with good visibility that permits analysis of the major capillaroscopic parameters were available in all patients. Among 32 included patients, 9 patients were with SSc, 12 cases with primary RP, and 10 patients with secondary RP in other CTD (7 patients with UCTD and 3 patients with SLE). „Scleroderma“ pattern was detected in 6 patients with SSc and in all these cases the capillaroscopic images were classifiable into one of the three distinct phases i.e., “early”, ”active” and ”late” phase. Presence of microvascular changes (“scleroderma-like” pattern) was detected also in 5 among the 10 patients with other CTD i.e., UCTD and SLE. In primary RP patients capillaroscopy revealed either normal pattern or nonspecific findings but without features of microangiopathy.Conclusion:Good capillaroscopic images, which could be analyzed and interpreted, are usually obtained using USB capillaroscope. This permits evaluation of the major capillaroscopic parameters. The available software although less sophisticated vs those of videocapillaroscopes, gives the opportunity for measurement of capillary diameters, mean capillary density, etc. The images received from USB capillaroscope are easily classified into “scleroderma”, “scleroderma-like”, non-specific changes and normal pattern. The most important conclusion from capillaroscopy is about presence or absence of microangiopathy. This was easily detected via USB capillaroscope that could be suggested as an ideal alternative for videocapillaroscopes in every day rheumatology practice especially at low budget cases. Measurements of capillary diameters and capillary density provide quantitative data that make these devises also appropriate for scientific research.References:[1]Cutolo M, Sulli A, Pizzorni C AS. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol. 2000;27(1):155–60.Disclosure of Interests:None declared.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1584.1-1585
Author(s):  
I. Gaisin ◽  
Z. Bagautdinova ◽  
R. Valeeva ◽  
N. Maximov ◽  
O. Desinova ◽  
...  

Background:Systemic sclerosis (SSc) is a connective tissue disease (CTD) most frequently associated with Raynaud’s phenomenon – RP (96%), followed by mixed CTD (MCTD) (86%), systemic lupus erythematosus – SLE (31%), undifferentiated CTD (30%), rheumatoid arthritis – RA (22%) and Sjogren’s disease – SD (13%)1. RP can manifest as a classical triple-colour change with pallor (ischaemic phase) followed by cyanosis (deoxygenation) and erythema (reperfusion)2,1. However, this triple-colour change only occurs in 19% of cases2,3. Majority of patients report an episodic double-colour change, consisting of pallor and cyanosis, pallor and erythema or cyanosis and erythema2. In a 4.8-year follow-up, 37.2% of RP patients developed rheumatic diseases (RD), 8.1% had other causes, in 54,7% RP remained primary4.Objectives:To study the incidence and manifestations of secondary RP in RD.Methods:A questionnaire survey conducted in 230 patients with RD.Results:RP was detected in 45.6% of RD patients (n=105), 54.4% of patients with RD had no RP (n=125). RP was 4 times more frequent in females than in males (F:M 4:1). In RP group, 87 patients (82%) had autoimmune RD: SSc (55.2%), SLE (17.1%), RA (6%),dermatomyositis (3.8%), cross syndrome (3.8%), MCTD (1.9%), SD (0.9%).Only 84% of RP patients had positive answers to all three questions that characterizeRP (1. Is there an unusual sensitivity of fingers to cold? 2. Do fingers change colorwhen exposed to cold? 3. Do they turn white and/or bluish?). Biphasic color changes (whitening-blueness; whitening-redness; blue-redness) were observed in 33 (31.4%) patients with RP, three-phase changes – in 32 patients (30.5%). Blueness of fingers to cold was more frequent in SLE than in SSc (p=0.027).Redness of fingers to cold occurred more often in cross syndrome, MCTD, SD, RA, vasculitis than in SSc (p<0.001) and in vasculitis than in SLE (p=0.035). In SSc patients, whitening of fingers to cold was more common than redness (p=0.037) and two-/three-phase changes of fingers color in the cold were more frequent than single-phase changes (p<0.001).The frequency of RP attacks was detected more than once a day in 44 (42%) patients. In 73% of cases, RP did not show signs of deep digital ischemia. Digital ulcers (active) were observed in 13 (12.3%) patients, fractures in a finger area – 23 (21.9%), digital scars – 15 (14.2%), phalange amputations – 7 (6.6%).Conclusion:Patients with RD and secondary RP most often have SSC (55%), less often – SLE (17%), RA (6%), DM (3%). In SSc and SLE patients, Raynaud’s reddening of fingers to cold is less common than in other RD. In SSc, two-/three-phase changes of fingers color in the cold are more frequent than single-phase changes. In SLE, fingers turn blue in the cold more often than in SSc.References:[1]Prete M, Fatone MC, Favoino E, Perosa F. Raynaud’s phenomenon: from molecular pathogenesis to therapy.Autoimmun Rev2014;13:655–67.[2]Linnemann B, Erbe M. Raynaud’s phenomenon – assessment and differential diagnoses.Vasa2015;44:166–77.[3]Heidrich H, Helmis J, Fahrig C, Hovelmann R, Martini N. Clinical characteristics of primary, secondary and suspected secondary Raynaud’s syndrome and diagnostic transition in the long-term follow-up. A retrospective study in 900 patients.Vasa2008;37 (Suppl. 73):3–25.[4]Pavlov–Dolijanovic S, Damjanov NS, VujasinovicStupar NZ, Radunovic GL, Stojanovic RM, Babic D. Late appearance and exacerbation of primary Raynaud’s phenomenon attacks can predict future development of connective tissue disease: a retrospective chart review of 3035 patients.RheumatolInt2013;33:921–6.Acknowledgments:Professor LP. Anan’eva, Professor RT. AlekperovDisclosure of Interests:Ilshat Gaisin Speakers bureau: Boehringer Ingelheim, KRKA, Berlin-Chemie Menarini, Sanofi, Zukhra Bagautdinova: None declared, Rosa Valeeva: None declared, Nikolay Maximov Speakers bureau: Pfizer, KRKA, Oxana Desinova: None declared, Rushana Shayakhmetova: None declared, Irina Sabelnikova: None declared, Anna Tukmacheva: None declared, Larisa Gibadullina: None declared, Natalya Burlaeva: None declared, Elena Agareva: None declared, Yulia Ochkurova: None declared, Tatyana Bragina: None declared, Ksenia Alexandrova: None declared, Elvira Reutova: None declared


2015 ◽  
Vol 4 (1) ◽  
pp. 13-15
Author(s):  
Binit Vaidya ◽  
Manisha Bhochhibhoya

Back grounds and Aims: Microvascular involvement of nailfold often occurs in systemic rheumatic diseases, especially scleroderma and related conditions. Nailfold capillaroscopy is easily performed non-invasive, simple, repeatable, sensitive, safe and inexpensive method to examine nailfold architecture by microscope.The normal capillaries are thin, symmetrical and have hair-pin appearance. Anomalies include dilated capillary loops, dropouts, tortuosity, avascular area, arborifications, megacapillaries, infracts,thrombsis and haemorrhages. This study aims to see the morphological changes in microcirculation in nailfolds of patients with Raynaud’s, which can be helpful in predicting the presence of connective tissue disorder.Methods: It is an observational study conducted at National Center for Rheumatic Diseases, Kathmandu from 26th March 2014 to 30th March 2015. Nailfolds of 8 fingers of both hands in 105 patients were examined using a hand held microscope.Results: Of 105 patients, 91 patients (86.6%) had abnormal morphological changes while 14 (13.4%) had no significant changes in microvessels. Normal patients had no underlying connective tissue disease(CTD) but those with abnormal findings had proven underlying CTD which included Lupus 6.5%, Scleroderma 17.5%, Rheumatoid Arthritis 14.2%, Mixed CTD7.6%, Undifferentiated CTD1.0%, Undifferentiated inflammatory arthritis 14.2%, Psorasis 1.0%, Rheumatoid Arthritis with scleroderma overlap 4.3%. No primary diagnosis was found in 32.9% of patients.Conclusion: Nailfold capillaroscopy allows direct examination of microvascular structure of a patient. Abnormal findings in a patient with Raynaud’s phenomenon might help to identify the presence of or future evolution into systemic connective tissue disorder.Journal of Advances in Internal Medicine 2015;04(01):13-15


2002 ◽  
Vol 46 (5) ◽  
pp. 1319-1323 ◽  
Author(s):  
Jean-Luc Cracowski ◽  
Patrick H. Carpentier ◽  
Bernard Imbert ◽  
Sandrine Cachot ◽  
Fran�oise Stanke-Labesque ◽  
...  

2020 ◽  
pp. 4495-4499
Author(s):  
David A. Isenberg ◽  
Ian Giles

About 1 in 20 people develop an autoimmune disease, many of which involve the musculoskeletal system. Young women are particularly at risk, but the development at any age of symptoms such as unexplained fever, rash, polyarthritis, Raynaud’s phenomenon, or mouth ulcers should encourage serological screening for autoimmune rheumatic or vasculitic disorder. The autoimmune rheumatic diseases are a heterogeneous group of disorders characterized by clinical involvement of the joints, connective tissues, muscles, internal organs, Raynaud’s phenomenon, and cutaneous manifestations. They include a broad clinical spectrum of disease, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjögren’s syndrome, scleroderma, dermatomyositis, polymyositis, antiphospholipid syndrome (APS), and the vasculitides.


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