INITIAL PREVALENCE AND INCIDENCE OF SECONDARY RAYNAUDS-PHENOMENON IN PATIENTS WITH RAYNAUDS SYMPTOMATOLOGY

Objective. To establish the initial prevalence and incidence of second ary Raynaud's phenomenon (RP) in an outpatient population presenting w ith RP and assessment of the discriminating and predictive value of th e variables of a diagnostic program. Methods. 112 patients (average fo llowup time 46 mo) were investigated prospectively. A screening progra m including anamnestic data, clinical examinations, noninvasive angiol ogic measurements, radiographic examinations, and laboratory chemistry was applied initially and repeated every 6 months. Patients with susp ected secondary RP according to the screening underwent an extended di agnostic 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 fol lowup another 5 patients were diagnosed as secondary RP (annual incide nce 1.4%). Using stepwise logistic regression, 7 screening variables w ere included in a model, leading to 96% correct classifications (sensi tivity 86%, specificity 100%). Most of these variables were also suita ble to predict the transition to secondary RP. An alternative classifi cation based on a total symptoms score led to 94% correct classificati ons (sensitivity 86%, specificity 96%). Conclusion. The diagnostic pro gram proved adequate and effective. patients with RP and related arter ial circulatory disorder showed a different clinical course than patie nts with an immunopathogenesis. A combination of several variables see ms to be superior, with respect to the prediction and differentiation of secondary RP, to an approach based on single variables.