Raynaud's phenomenon
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phenomenon Classification and external resources
Raynaud's phenomenon (pronounced /re??no?z/) (r?y-N?Z),
in medicine, is a vasospastic disorder causing discoloration
of the fingers, toes, and occasionally other extremities.
This condition can also cause nails to become brittle with
longitudinal ridges. Named for French physician Maurice
Raynaud (1834 - 1881), the cause of the phenomenon is
believed to be the result of vasospasms that decrease blood
supply to the respective regions.
Emotional stress and cold are classic triggers of the
phenomenon, and the discoloration follows a
characteristic pattern in time: white, blue and red.
It comprises both Raynaud's disease (primary Raynaud's),
where the phenomenon is idiopathic, and Raynaud's syndrome
(secondary Raynaud's), where it is caused by some other
instigating factor. Measurement of hand-temperature
gradients is one tool used to distinguish between the
primary and secondary forms.
It is possible for the primary form to progress to
the secondary form.
Contents
-Incidence
-Epidemiology
-Symptoms
-Investigations
-Pathophysiology
-Treatment
-General measures
-Emergency measures
Incidence
The phenomenon is more common in women than men, with the
Framingham Study finding that 5.8% of men and 9.6% of women
suffered from it.
Epidemiology
There is a familial component to primary Raynaud's, and
presentation is typically before two. Smoking worsens
frequency and intensity of attacks, and there is a hormonal
component. Sufferers are more likely to have migraine and
angina than controls.
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Secondary Raynaud's has a number of associations:
Connective tissue disorders: |
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scleroderma
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systemic
lupus erythematosus
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rheumatoid arthritis
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Sjögren's syndrome
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dermatomyositis
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polymyositis
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Eating disorders
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Anorexia Nervosa
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Obstructive disorders
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atherosclerosis
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Buerger's disease
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subclavian aneurysms
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thoracic outlet syndrome
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Drugs
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Beta-blockers
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cytotoxic drugs - particularly
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chemotherapeutics and most
especially
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bleomycin
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cyclosporine
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ergotamine
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sulfasalazine
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Occupation
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jobs involving vibration,
particularly drilling
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exposure to vinyl chloride,
mercury
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exposure to the cold (e.g. by
working
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packing frozen food)
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Others
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hypothyroidism
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cryoglobulinemia
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malignancy
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reflex sympathetic dystrophy
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It is important to realize that Raynaud's can herald these
diseases by periods of more than 20 years in some cases,
making it effectively their first presenting symptom. This
can be the case in the CREST syndrome, of which Raynaud's is
a part.
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