Dr. Mohamad Ali Rida
Rheumatology
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Patient's Query
Hello doctor,
I have Raynaud's phenomenon, can primary Raynaud's alone cause high ANA? I have underlying chronic urticaria syndrome. Recently, my skin has become even more sensitive than usual (rubbing against my bed has torn skin), there is sweating from my forehead even when not hot. I am currently on a 6 % Hydroquinone, Bilastine 20 mg twice a day, and Rosiver cream and Doxycycline 150 mg, and Adren-All 20 mg twice a day.
Hi,
Welcome to icliniq.com.
Usually, primary Raynaud's is not associated with any other disease. However, with your background of urticaria (autoimmune) and positive anti-nuclear antibodies (ANA), I would dig more towards secondary Raynaud's. For now, we can observe any vasculitis symptoms, including abnormal skin rash, pulmonary symptoms, neuropathy, etc. The next step is to do an ANA profile or extractable nuclear antigen (ENA), which tells us which antibodies are positive in the ANA group and what symptoms we should expect or look for carefully.
Patient's Query
Hello doctor,
Is it possible to have an elevated ANA with primary Raynaud's? Or, if my ANA is positive, does this mean there is no way it could be primary? If secondary, what are the possible or likely scenarios?
Hi,
Welcome back to icliniq.com.
Yeah, having a positive anti-nuclear antibody (ANA) will raise the possibility of secondary Raynaud's. According to the ANA profile, we can conclude what the scenarios are. Almost all autoimmune diseases, including scleroderma, lupus, and Sjogren, can cause that. Also, small vessel inflammation vasculitis can be a cause. Nevertheless, we only treat Raynaud symptomatically until we have other systemic symptoms of autoimmune diseases.
Patient's Query
Hello doctor,
So it is not at all possible that primary Raynaud's is the cause of the increased ANA? Do my hands look like scleroderma hands, or are they fine?
Hi,
Welcome back to icliniq.com.
It is possible, however, not common at all. Your hands look very dry (attachment removed to protect the patient's identity); however, it is difficult to tell if they are scleroderma hands based on pictures. We need to examine them and see their rigidity. Your best option is to go for the anti-nuclear bodies (ANA) or extractable nuclear antigen (ENA). If negative, then you can be reassured that it is primary Raynaud's, and you are one of the 5 % healthy people with positive ANA.
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Rheumatology
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