Oral L-arginine can reverse digital necrosis in Raynaud's phenomenon

Raynaud's phenomenon is characterized by transient reduction in blood supply through the small arteries in the hands and feet. Severe Raynaud's phenomenon can cause digital necrosis. It has been hypothesized that nitric oxide may have a role in Raynaud's phenomenon. We report two cases in which oral L-arginine reversed digital necrosis in Raynaud's phenomenon and two additional cases in which the symptoms of severe Raynaud's phenomenon were improved with oral L-arginine. These reports suggest that a defect in nitric oxide synthesis or metabolism is present in Raynaud's phenomenon. They also suggest a potential role for oral L-arginine therapy in Raynaud's phenomenon, especially in Raynaud's phenomenon with digital necrosis.