Initial prevalence and incidence of secondary Raynaud's phenomenon in patients with Raynaud's symptomatology.
OBJECTIVE
To establish the initial prevalence and incidence of secondary Raynaud's phenomenon (RP) in an outpatient population presenting with RP and assessment of the discriminating and predictive value of the variables of a diagnostic program.


METHODS
112 patients (average followup time 46 mo) were investigated prospectively. A screening program including anamnestic data, clinical examinations, noninvasive angiologic measurements, radiographic examinations, and laboratory chemistry was applied initially and repeated every 6 months. Patients with suspected secondary RP according to the screening underwent an extended diagnostic program.


RESULTS
Based on the initial screening, 73 patients were classified as primary RP and 39 patients as suspected secondary RP. After examinations of the extended diagnostic program, 16 patients were diagnosed as secondary RP (initial prevalence 14.3%). During followup another 5 patients were diagnosed as secondary RP (annual incidence 1.4%). Using stepwise logistic regression, 7 screening variables were included in a model, leading to 96% correct classifications (sensitivity 86%, specificity 100%). Most of these variables were also suitable to predict the transition to secondary RP. An alternative classification based on a total symptoms score led to 94% correct classifications (sensitivity 86%, specificity 96%).


CONCLUSIONS
The diagnostic program proved adequate and effective. Patients with RP and related arterial circulatory disorder showed a different clinical course than patients with an immunopathogenesis. A combination of several variables seems to be superior, with respect to the prediction and differentiation of secondary RP, to an approach based on single variables.
Hirschl
M
M
Department of Angiology, Hanusch Hospital, Vienna, Austria.
Kundi
M
M
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D011928:Raynaud Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D012044:Regression Analysis; D012680:Sensitivity and Specificity