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Raynaud's phenomenon.

J J Belch1

  • 1Ninewells Hospital and Medical School, University of Dundee, Scotland.

Current Opinion in Rheumatology
|December 1, 1991
PubMed
Summary
This summary is machine-generated.

Raynaud's phenomenon involves episodic digital ischemia triggered by cold and emotion, often linked to connective tissue diseases. Early autoantibody detection and nailfold microscopy aid diagnosis and management of this vasospasm disorder.

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Area of Science:

  • Vascular Medicine
  • Immunology
  • Rheumatology

Background:

  • Raynaud's phenomenon is characterized by episodic digital ischemia, often triggered by cold or emotion.
  • It is frequently associated with connective tissue diseases (CTDs) and other conditions like Sjögren's syndrome and malignancy.
  • Vasospasm in Raynaud's can extend beyond the extremities, affecting areas like the inner ear and placental vessels.

Purpose of the Study:

  • To review current understanding of Raynaud's phenomenon etiology and associations.
  • To highlight diagnostic approaches combining immunologic testing and nailfold vessel microscopy.
  • To discuss contributing factors and current treatment strategies for vasospasm.

Main Methods:

  • Literature review of recent information on Raynaud's phenomenon.
  • Discussion of etiological factors including alpha 2-adrenoceptor responsiveness and neuropeptide levels.
  • Examination of diagnostic tools such as autoantibody presence and nailfold microscopy.

Main Results:

  • The presence of autoantibodies significantly increases the risk (63-fold) of developing CTDs.
  • Factors like cold-induced alpha 2-adrenoceptor responsiveness, calcitonin gene-related peptide deficiency, and excess endothelin are implicated.
  • Nailfold vessel microscopy is a valuable adjunct to immunologic testing.

Conclusions:

  • Raynaud's phenomenon is a complex condition with diverse associations and underlying pathophysiological mechanisms.
  • Early identification of autoantibodies and use of nailfold microscopy can improve diagnostic accuracy.
  • Current treatments focus on managing vasospasm and addressing altered blood constituents symptomatically.