title: [Raynaud's phenomenon - first sign of malignancy: case report].
abstract: Raynaud's phenomenon is a common phenomenon in the general population. It most commonly occurs in healthy individuals, in whom there is no associated illness or any other cause of Raynaud's phenomenon (primary or idiopathic Raynaud's phenomenon). Secondary Raynaud's phenomenon is common with rheumatic diseases (systemic sclerosis, systemic lupus erythematosus, primary Sjögren's syndrome, mixed connective tissue disease, etc.), occlusive vascular diseases, hematologic disorders, use of vibrating tools and use of some medications, and rarely with malignancy. We report on a patient who presented with a three-week history of painful Raynaud's attacks, which was the reason for seeking assistance of internists in emergency clinic. Upon admission to the hospital and diagnostic work-up, adenocarcinoma of the lung was found. Antinuclear antibodies (ANA), anti-dsDNA antibodies, anticardiolipin IgM and IgG antibodies were present in a lower titer. It is known that rheumatoid factor or ANA characteristic of rheumatic disease are often present in patients with paraneoplastic rheumatic syndromes, which can lead to wrong conclusions about the possible systemic connective tissue diseases and ultimately delay the correct diagnosis. The first appearance of Raynaud's phenomenon as an isolated symptom in people older than 50, with painful signs of ischemia, as in our patient, or the occurrence of asymmetric grasping fingers, especially in men, regardless of the presence of RF, ANA, anti-dsDNA or other autoantibodies, requires broader diagnostic evaluation for malignancy.
authors.forename: Anamarija
authors.initials: A
authors.lastname: Sutić
authors.forename: Gudelj
authors.initials: G
authors.lastname: Gračanin
authors.forename: Jadranka
authors.initials: J
authors.lastname: Morović-Vergles
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis*; D000974:Antibodies, Antinuclear / Q000097:blood*; D018450:Disease Progression; D042241:Early Diagnosis; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011928:Raynaud Disease / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology
chemical_list: D000974:Antibodies, Antinuclear