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Raynaud's phenomenon - Management
Basis for recommendation
These recommendations are based on:
- Expert opinion from a number of published review articles in relation to methods of detecting an underlying disease [Isenberg and Black, 1995; Wigley, 2002; Gayraud, 2007; Pope, 2007b; Bakst et al, 2008; Raynaud's & Scleroderma Association, 2008] and external reviewer opinion.
- All but one review [Pope, 2007b] advised that anti-nuclear antibodies should be checked routinely in people with Raynaud's phenomenon, regardless of age or gender.
- Evidence from a meta-analysis of studies for predictors of transition from primary to secondary Raynaud's phenomenon, which showed that normal nail-fold capillary pattern and negative anti-nuclear antibodies provide reassurance that a person with primary Raynaud's syndrome is very unlikely to develop an underlying connective tissue disease [Spencer-Green, 1998]. A subsequently-published cohort study also found that positive anti-nuclear antibodies and abnormal nail-fold capillaries were associated with a increased risk of transition to secondary Raynaud's phenomenon [Hirschl et al, 2006].
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