Raynaud’s phenomenon – what is this disease?

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Raynaud’s phenomenon is a condition characterized by numbness in the fingers and toes, and freezing of the nose and ears. Its essence is excessive vasoconstriction caused by stress, low ambient temperature or intensive manual activities. The etiology of this vasomotor disorder is unknown.

1. The most common symptom is numbness and bluish fingers, accompanied by pain
2. The occurrence of such symptoms should be a signal to contact a doctor
3. Raynaud’s disease threatens, inter alia, pianists, but also young women
4. More information can be found on the Onet homepage

What is Raynaud’s disease and syndrome?

Raynaud’s phenomenon is a vasomotor disorder of unknown etiology characterized by sudden pale, then bruising and redness of the fingers, toes, rarely the nose and ears, accompanied by numbness and pain. They are divided into primary disorder, also called Raynaud’s disease and secondary, accompanying other diseases, referred to as Raynaud’s syndrome.

The incidence of Raynaud’s phenomenon is about 3-4 percent. population. In areas with cool climates, its presence is estimated at around 30%. It is most often found in young women with a family burden.

Clinical picture of Raynaud’s disease

Raynaud’s disease usually affects people between the ages of 15 and 45. The classic symptom is your fingers turning pale and tingling under the influence of cold or stress. Then they become bluish and numb, and after some time, reddening with a feeling of pain. The fingers and the toes are often affected. Moreover, the symptom may appear in the area of ​​the auricles, tongue, nose and lips. Some people may develop finger ulcers and even necrosis of the fingertips.

The discoloration in Raynaud’s syndrome is usually well-defined and affects one or more fingers. In patients there is:

1. fading – characteristic of the ischemic phase; arises as a result of contraction of arterioles in the area of ​​the fingers;
2. cyanosis – the lack of proper blood supply leads to the expansion of veins and capillaries, which causes deoxygenated blood to remain in the vessels;
3. hyperemia – occurs during heating due to the stopping of contraction of the arteries of the fingers and an increase in blood flow through the arterioles and capillaries.

Read more about the possible causes of numbness in the fingers on the left hand.

Raynaud’s disease

After the secondary causes of Raynaud’s phenomenon have been ruled out, the term is usually referred to as Raynaud’s disease. The tendency to its occurrence is greater in the female sex (up to five times greater than in men). Most often it affects people between 20 and 40 years of age. It is worth mentioning that half of the patients with Raynaud’s disease have Raynaud’s disease. The fingers are affected in the course of the disease. At first, the disease may affect one or two fingertips, and over time it may affect the entire finger or even all of the fingers. Diagnostics is not easy at all. Doctors very often do not notice any abnormalities, e.g. in the radial arteries, elbows and feet – the pulse is normal. In some group of patients, thickening of the subcutaneous tissue in the area of ​​the fingers is observed.

According to specialists, Raynaud’s phenomenon is much milder in people suffering from the disease.

Raynaud’s disease – causes

Raynaud’s disease and syndrome may occur in the following conditions:

1. limb obliterating atherosclerosis,
2. systemic lupus erythematosus,
3. mixed connective tissue disease,
4. rheumatoid arthritis,
5. polymyositis and dermatomyositis,
6. polyarteritis nodosa,
7. Wegener’s granulomatosis,
8. systemic scleroderma,
9. Behcet’s disease,
10. Thromboembolic vasculitis (young men who smoke are particularly at risk),
11. disorders of the blood composition (this is especially the case in patients suffering from cold agglutinin syndrome, Waldenstrom’s macroglobulinemia, cryofibrinogenemia or cryoglobulinemia.

People diagnosed with infective endocarditis, Lyme disease, infectious mononucleosis and hepatitis B and C are also at risk of the disease.

Raynaud’s disease and syndrome are very common in people suffering from fibromyalgia, pulmonary hypertension and cancer, and diseases with increased blood viscosity, such as cryoglobulinemia, multiple myeloma, lymphomas and leukemias, polycythemia vera and thrombocytopenia. Also, compression syndromes such as carpal tunnel syndrome and upper thoracic outlet syndrome are at risk of developing this disease. Raynaud’s disease and syndrome are common also in people who take certain cardiac medications, oral contraceptives and immunosuppressants (cyclosporin A, methotrexate). Occupational exposure to heavy metals: lead and thallium, as well as to vinyl chloride is also very important. Therefore, operators of jackhammers, petrol saws in forestry and hand-held drilling rigs in mining, as well as computer typists, pianists and refrigeration workers, often fall ill with the disease.

Check if you suffer from carpal tunnel syndrome.

How is Raynaud’s disease diagnosed?

The diagnosis of Raynaud’s disease is made by the doctor on the basis of an interview, physical examination and additional tests. The diagnosis of clinical symptoms of diseases in the course of which Raynaud’s phenomenon is present allows for the diagnosis of Raynaud’s syndrome.

Getting a diagnosis is very important in people at high risk of developing Raynaud’s syndrome. These include people with Raynaud’s phenomenon before the age of 30 and all those with trophic changes (ulceration, necrosis) in the fingertips and patients with systemic connective tissue diseases.

In patients who experience paroxysmal paling of the fingers and toes under the influence of emotions or cold, the doctor makes a provocation test. During the examination, the patient’s hands or feet should be immersed in cold water for a few minutes or placed under a stream of cold water. In addition, blood tests (necessary to determine the cause of Raynaud’s phenomenon) are performed. A positive test result combined with symptoms may indicate that this is Raynaud’s syndrome.

Treatment of Raynaud’s phenomenon

Most patients with primary Raynaud’s syndrome do not require therapy. People with a secondary form of the disease should be treated, unfortunately treatment is usually ineffective. Treatment of Raynaud’s syndrome is to treat the underlying disease and symptoms of vasospasm. Prevention is essential. Therefore, the doctor should first of all explain what the disease is and what are the ways to prevent it. The key is to avoid exposure to cold, to quit smoking, to limit the consumption of caffeinated beverages and to discontinue contraceptives and preparations that cause blood vessel spasm (e.g. some cardiological medications).

Learn about common diseases of the blood system.

In some situations, when the disease is severe and the preventive measures have failed, pharmacotherapy is used. Then the following apply:

1. sympatholytic preparations in the form of pentoxybenzamine, guanethidine and methyldopa;
2. calcium channel blockers, particularly in reducing symptoms of Raynaud’s syndrome, e.g. felodipine, nifedipine, isradipine and amlodipine;
3. α1-adrenergic post-synaptic antagonists – doxazosin, prazosin and terazosin are effective.

Sympathectomy is performed in patients who do not respond to pharmacological treatment. It involves the destruction of the sympathetic nerve that supplies blood vessels.

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