Advertisement

Clinical Rheumatology

, Volume 12, Issue 1, pp 70–73 | Cite as

Elevated anticardiolipin antibodies in a patient with vibration-white-finger, valvular heart disease and psoriatic arthritis

  • N. J. McHugh
  • D. M. Elvins
  • E. F. J. Ring
Case Report

Summary

We describe a case of irreversible severe vibration-white-finger (VWF) occurring in a male who used a compression-hammer daily at work for a 20-year period. Infra-red thermography following either a cold provocation or a vibratory stress was a sensitive objective method of documenting the condition. Persistent elevation of IgG anticardiolipin antibodies (aCL) was found in his serum and may be a marker of endothelial damage associated with either VWF or the patient's coincidental valvular heart disease.

Key words

Raynaud's Phenomenon Vibration-White-Finger Antiphospholipid Antibody Thermography 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Pryykko, I. Clinical aspects of the hand-arm vibration syndrome. Scand J Work Inviron Health 1986, Spec. 12 (4), 439–447.Google Scholar
  2. 2.
    Kakosy, T. Vibration disease. Balliere's Clinical Rheumatology, 1989, 3, 25–50.Google Scholar
  3. 3.
    Olsen, N. Centrally and locally mediated vasomotor activities in Raynaud's phenomenon. Scand J Work Environ Health 1987, 13, 309–312.PubMedGoogle Scholar
  4. 4.
    Pyykko, I., Gemme, G. Pathophysiological aspects of peripheral circulatory disorders in the vibration syndrome. Scand J Work Environ Health, 1987, 13, 313–316.PubMedGoogle Scholar
  5. 5.
    Blunt, R.J., George, A.J.; Hurlow, R.A., Strachan, C.J.L., Stuart, J. Hyperviscosity and thrombotic changes in idiopathic and secondary Raynaud's syndrome. Br J Haematol 1980, 45, 651–658.PubMedGoogle Scholar
  6. 6.
    Taylor, W. Hand-arm vibration syndrome: a new clinical classification and an updated British standard guide for hand transmitted vibration. Br J Ind Med 1988, 45, 281–282.PubMedGoogle Scholar
  7. 7.
    Ring, E.F.J. Quantitative thermal imaging. Clin Phys Physiol Meas 1990, 11, Suppl. A, 87–95.CrossRefPubMedGoogle Scholar
  8. 8.
    Harris, E.N. The second international anti-cardiolipin standardization workshop/the Kingston anti-phospholipid antibody study (KAPS) Group, Am J Clin Pathol 1990, 94, 476–484.PubMedGoogle Scholar
  9. 9.
    McHugh, N.J., Ah Moye, D., James, I.E., Sampson, M., Maddison, P.J. The presence of a lupus anticoagulant is of additional clinical significance in anticardiolipin positive SLE patients. Ann Rheum Dis 1991, 50, 548–542.PubMedGoogle Scholar
  10. 10.
    Takeuchi, T., Futatsuka, M., Imanishi, H. et al. Pathological changes observed in finger biopsy from patients with vibration-induced white finger. 4th International Symposium on Hand-Arm Vibration 1985, Helsinki p 96.Google Scholar
  11. 11.
    Ashe, W.F., Cook, W.T., Old, J.W. Raynaud's phenomenon of occupational origin. Arch Environ Health 1962, 5, 333–343.PubMedGoogle Scholar
  12. 12.
    Praglowske, T., Misiewicz, A. Histopathologic changes in skin of fingertips in angioneurosis vibratoria. (Polish) Medycyna Pracy 1972, 23, 140–154.Google Scholar
  13. 13.
    Sammaritano, L.R., Gharavi, A.E., Lockshin, M.D. Antiphospholipid antibody syndrome: immunological and clinical aspects. Semin Arthritis Rheum 1990, 20 (2), 81–96.CrossRefPubMedGoogle Scholar
  14. 14.
    McNeil, H.P., Ghesterman, C.N., Krilis, S.A. Antiphospholipid antibodies are directed against a complex antigen which includes a lipid-binding glycoprotein. Proc Natl Acad Sci USA, 1990, 87, 4120–4124.PubMedGoogle Scholar
  15. 15.
    Nerem, R.M. Vibration-induced arterial shear stresses. Lancet 1971, i. 78.Google Scholar
  16. 16.
    Lau, C.S., McClaren, M., Chopra, M., Belch, J.J.F. Vibration induced white finger syndrome:? a true secondary Raynaud's phenomenon. Br J Rheumatol 1989, 28 (suppl 2) 15.Google Scholar
  17. 17.
    Khamashta, M., Cervera, R., Asherson, R.A., Font, J., Gil, A., et al. Association of antibodies against phospholipids with heart valve disease in systemic lupus erythematosus. Lancet 1990, 335, 1541–44.CrossRefPubMedGoogle Scholar
  18. 18.
    Harris, E.N., Chan, J.K.H., Asherson, R.A., Aber, V.R., Gharavi, A.E., Hughes. Thrombosis, recurrent fetal loss and thrombocytopenia: predictive value of the anticardiolipin antibody test. Arch Intern Med 1986, 146, 2153–2156.CrossRefPubMedGoogle Scholar
  19. 19.
    Dupuis, H. Thermographic assessment of skin temperature during a cold provocation test. Scand J Work Environ J Health 1987, 13, 352–355.Google Scholar

Copyright information

© Acta Medica Belgica 1993

Authors and Affiliations

  • N. J. McHugh
    • 1
  • D. M. Elvins
    • 1
  • E. F. J. Ring
    • 1
  1. 1.Royal National Hospital for Rheumatic Diseases, Upper Borough WallsBathEngland

Personalised recommendations