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Impact of Hallmark Autoantibody Reactivity on Early Diagnosis in Scleroderma

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Abstract

Raynaud's phenomenon often precedes the diagnosis of systemic sclerosis and is the first symptom of the disease in many cases. Antinuclear antibody positivity can assist in the early identification of cases of isolated Raynaud's phenomenon likely to progress to systemic sclerosis. However, the specific differences between rate of progression for different scleroderma hallmark antibodies is less clear. We review the predictive potential of ANA positivity and nailfold capillaroscopy for identifying cases of Raynaud's phenomenon which may progress to connective tissue diseases. We also have reviewed data from our own large scleroderma cohort to explore the relationship between antibody subtype and time to development of SSc. Duration of pre-existing Raynaud's phenomenon may be an important determinant of the profile of systemic sclerosis cases identified through screening. Ninety-five percent of our patients with isolated Raynaud's phenomenon, negative autoimmune serology on more than one visit and normal capillaroscopy score showed no progression to connective tissue disease. Duration of antecedent Raynaud's phenomenon differs between disease subsets and scleroderma-specific ANA patterns.

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Competing Interests

The authors declare no competing interest.

Statement of Funding Sources

The on-going clinical research activities in our department are supported by funding from Arthritis Research UK, The Raynaud's and Scleroderma Association and EULAR through the Orphan Diseases Programme. PM was supported by a German ADF/DDG grant.

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Authors and Affiliations

  1. Centre for Rheumatology, Royal Free Hospital and UCL Medical School, London, UK

    Pia Moinzadeh, Svetlana I Nihtyanova, Kevin Howell, Voon H Ong & Christopher P Denton

  2. Centre for Rheumatology and Connective Tissue Diseases, UCL Medical School, Royal Free Hospital, London, NW3 2QG, UK

    Christopher P Denton

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  1. Pia Moinzadeh
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  2. Svetlana I Nihtyanova
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Correspondence to Christopher P Denton.

Additional information

Pia Moinzadeh, Svetlana I Nihtyanova contributed equally to this work.

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Moinzadeh, P., Nihtyanova, S.I., Howell, K. et al. Impact of Hallmark Autoantibody Reactivity on Early Diagnosis in Scleroderma. Clinic Rev Allerg Immunol 43, 249–255 (2012). https://doi.org/10.1007/s12016-012-8331-1

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