Raynaud's
Phenomenon
Raynaud's
phenomenon or, simply, Raynaud's, is a disorder
characterized by decreased blood flow - usually
to the fingers, and less frequently to the ears,
toes, nipples, knees, or nose. Vascular spasms
usually occur as attacks in response to cold exposure
or emotional upset.
Raynaud's
can occur alone or may occur with other diseases.
The diseases most frequently associated with Raynaud's
are autoimmune or connective tissue diseases,
among others, such as the following:
- systemic lupus erythematous
(lupus)
- scleroderma
- CREST syndrome ( c
alcium skin deposits, R aynaud's phenomenon,
e sophageal dysmotility, s clerodactyly, t elangiectasis)
- Buerger's disease
- Sjögren's
syndrome
- rheumatoid arthritis
- occlusive vascular
disease
- polymyositis
- cryoglobulinemia
The
exact cause of Raynaud's is unknown. One theory
links blood disorders characterized by increased
platelets or red blood cells that may increase
the blood thickness. Another theory involves the
special receptors in the blood that control the
constriction of the blood vessels being more sensitive
in individuals with Raynaud's.
What
is a risk factor?
A
risk factor is anything that may increase a
person's chance of developing a disease.
It may be an activity, such as smoking, diet,
family history, or many other things. Different
diseases have different risk factors.
Although
these factors can increase a person's risk,
they do not necessarily cause the disease. Some
people with one or more risk factors never develop
a disease, while others develop the disease
and have no known risk factors.
But,
knowing your risk factors to any disease can
help to guide you into the appropriate actions,
including changing behaviors and being clinically
monitored for the disease.
There
are certain diseases or lifestyle choices that
can increase a person's risk for developing
Raynaud's. These risk factors include the
following:
- existing connective
tissue or autoimmune disease
- cigarette smoking (in
men)
- alcohol use (in women)
- Helicobacter pylori
(H. pylori) - a spiral-shaped bacterium found
in the stomach, which (along with acid secretion)
damages stomach and duodenal tissue, causing
inflammation and peptic ulcers.
The
following are the most common symptoms of Raynaud's
phenomenon. However, each individual may experience
symptoms differently. Symptoms may include:
- a pattern of color
changes in the fingers as follows: pale/white
followed by blue then red when the hands are
warmed; color changes are usually preceded by
exposure to cold or emotional upset
- hands may become swollen
and painful when warmed
- ulcerations of the
finger pads develop (in severe cases)
- gangrene may develop
in the fingers leading to amputation (in about
10 percent of the severe cases)
There
are no specific laboratory tests that can confirm
a diagnosis of Raynaud's phenomenon. Instead,
diagnosis is usually based on reported symptoms.
Your physician may perform a cold challenge test
to bring out color changes in the hands.
Specific
treatment for Raynaud's phenomenon will be
determined by your physician based on:
- your age, overall health,
and medical history
- extent of the disease
- your signs and symptoms
- your tolerance for
specific medications, procedures, and therapies
- expectation for the
course of the disease
- your opinion or preference
Although
there is no cure for Raynaud's phenomenon,
the disorder can often be successfully managed
with proper treatment. Treatment may include:
- preventative measures
such as wearing gloves or avoiding cold exposure
- smoking cessation
- wearing finger guards
over ulcerated fingers
- avoiding trauma or
vibration to the hand (such as vibrating tools)
- medications that are
usually used to treat high blood pressure (antihypertensive
medications) may be given during the winter
months (to help reduce constriction of the blood
vessels)
Individuals
who first experience Raynaud's phenomenon
in their 40s may be tested for an underlying
disease. The primary form of Raynaud’s is
the most common type. It is less severe, and few
people with this form develop another related
condition.
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