Investigations
- 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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