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Distinguishing Primary From Secondary Raynaud's Disease

Duplex scanning of carotid elasticity or stiffness is a useful non-invasive clinical tool for distinguishing between primary and secondary Raynaud's disease, suggest researchers in England.

Primary Raynaud's disease can be difficult to differentiate clinically from the secondary form with an underlying connective tissue, haematological, neurovascular or drug-induced disorder. The researchers sought to assess if elastic carotid and muscular femoral arterial biomechanical properties and intima-media thickness (IMT) could distinguish between the two disorders.

They found that duplex determination of the carotid elasticity or stiffness differs between primary and secondary forms of the disease and, along with autoantibody markers and nail-fold capillaroscopy, is a useful, non-invasive tool for distinguishing them.

Dr K S Cheng and colleagues from Royal Free and University College Medical School, University College London and The Royal Free Hospital, London, did this study.

Twenty patients with primary and 53 with secondary Raynaud's linked with scleroderma (systemic sclerosis, SSc) participated in the study. Their carotid and femoral wall mechanics were measured with a duplex scanner coupled to a Wall Track system. Investigators also documented their age, gender, body mass index, heart rate, systolic and diastolic blood pressures, presumed cardiovascular load, plasma creatinine, fasting cholesterol and triglyceride and glucose concentrations.

In patients with secondary Raynaud's disease, the carotid elastic properties were significantly impaired, even after the investigators took into account potentially influencing physiological and biochemical variables.

There were no statistical differences in the femoral elastic properties or the carotid and femoral IMTs between the two groups.
Eur J Vasc Endovasc Surg 2003 Apr;25:4:336-41. "Differentiation of Primary and Secondary Raynaud's Disease by Carotid Arterial Stiffness"

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