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Investigations

Authoring team

  • FBC - normocytic normochromic anaemia. "Cold" agglutinins associated with Raynaud's phenomenon may be evident.
  • ESR - raised
  • antinuclear antibodies - often positive, with raised antinucleolar and anticentromere antibodies
  • rheumatoid factor - positive in 30% of cases
  • complement levels - normal
  • radiology - there may be:
    • subcutaneous calcification around the fingers
    • erosion and resorption of distal phalanges in severe cases
    • barium studies may reveal oesophageal dysmotility or stricture; more accurately assessed by oesophageal manometry
    • pulmonary fibrosis and impaired diffusion
  • renal function tests - may show rapid renal failure

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