The titre of anti-centromere antibodies: its relationship to Raynaud's phenomenon and vascular occlusion.

A retrospective survey of all patients with positive anti-centromere antibody (ACA) determinations over a 5-year period was undertaken. Of the 52 patients identified, seven denied symptoms of Raynaud's phenomenon, all of whom had antibody titres of 2560 or less. One of these showed a 16-fold increase in titre with the onset of Raynaud's, 12 years after original presentation. The remaining 45 patients experienced Raynaud's on cold exposure. Within this group, seven developed thrombotic vascular disease, five of whom were associated with an ACA titre of 20,480 or above. Another two with similar high ACA titres developed hyper-reninaemic hypertension, suggesting disease of the renal vasculature and associated ischaemia. Where it was possible to ascertain, seven of eight with high titre ACA developed sclerodactyly. In contrast, this was not seen in those with low titre ACA of 2560 or less and who also denied Raynaud's phenomenon.