Some Patients With Raynaud’s Phenomenon Fit Systemic Sclerosis 2013 Criteria But Not 1980

In a recent study published in the journal Arthritis Research & Therapy, a research team from the Yonsei University College of Medicine in Seoul, South Korea found that patients with Raynaud’s phenomenon (RP) met 2013 American College of Rheumatology/European League Against Rheumatism criteria for systemic sclerosis but did not meet the 1980 American College of Rheumatology criteria.

Raynaud’s phenomenon (RP) is a reversible vasculopathy characterized by pallor and cyanosis due to cold-induced paroxysmal spasms of the digital vessels and hyperemia in the recovery phase. Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by vasculopathy and fibrosis of both the skin and internal organs, with pulmonary arterial hypertension, interstitial lung disease and gastrointestinal manifestations. The typical pathological features of SSc are mostly progressive and irreversible, so it could often reduce one’s quality of life and be fatal enough to shorten life expectancy.

In the study titled “Application of the 2013 ACR/EULAR classification criteria for systemic sclerosis to patients with Raynaud’s phenomenon,” Min-Chan Park and colleagues evaluated a total 64 patients with RP and 60 patients with systemic sclerosis (SSc). The research team used the new ACR classification criteria and compared the parameters among those who were newly classified as SSc and those who were not or previously classified as SSc.

Results revealed that 17 of the total 64 patients with RP that did not meet the 1980 ACR classification criteria were newly classified as SSc by the 2013 ACR/EULAR classification criteria.

Results also revealed that a total of 33 of the 64 patients had other autoimmune conditions, such as Sjögren’s syndrome, systemic lupus erythematosus, mixed connective tissue disease and rheumatoid arthritis.

The newly SSc classified patients showed increased frequencies of sclerodactyly, digital tip ulcer, telangiectasia, abnormal nailfold capillaries and the presence of anti-centromere antibody, compared to those not and telangiectasia and anti-centromere antibody, compared to the previously classified patients.

Based on the results, the researchers concluded that overall, 26.5% of the patients with RP that did not meet the 1980 ACR classification criteria were newly classified as SSc according to the 2013 ACR/EULAR classification criteria. Sclerodactyly, telangiectasia, and the presence of anti-centromere antibody had independent predictive value for reclassifying patients with RP as SSc.