Raynaud Disease

Test Yourself Answer To Question: a 36-year-old female with a 10-year history of intermittent numbness and loss of color in the fingers, toes, and nose

“…Raynaud's phenomenon is classified as primary or secondary [1]. Primary Raynaud's phenomenon typically affects young women in the 2nd-3rd decades [1,4], whereas secondary Raynaud's phenomenon usually arises after the 3rd decade [1]. Clinical symptoms tend to be milder in primary Raynaud's phenomenon, where digital ulceration and systemic involvement are rare [1].…”

“…This is likely to involve a combination of excessive release of vasoconstrictive mediators, exaggerated vasoconstrictive response, and reduced vasodilatory response [1,9]. Endothelin-1 and calcitonin generelated peptide are key influencers of these systems, the former responsible for vasoconstriction and the latter released from sensory afferents and resulting in vasodilatation [2,4,9]. Activation of alpha2 adrenoreceptors, structural abnormalities of large and small vessels, and disordered coagulation, including increased platelet aggregation and blood viscosity, have also been implicated [4,9].…”

Raynaud's phenomenon manifesting as progressive abnormal MRI bone marrow signal in the toes

“…Cold temperatures can induce a sympathetic response that causes reflex cutaneous vasoconstriction, and this response can be amplified in people with RP [16]. While this pathogenesis is not completely understood, authors have proposed causes associated with overproduction of endothelin-1, enhanced platelet aggregation, a calcitonin gene-related peptide deficiency, altered blood viscosity, and augmented response alpha-2 sympathetic receptors [17].…”

State of the art review: The management of chronic vascular disorders in the hand and upper limb

“…These changes can even occur during an office visit and range from a pale colour seen with vasospasm, to a purplish colour that can occur with rewarming/reperfusion. It is thought to occur as the result of digital artery vasoconstriction due to cold temperatures, blunt trauma and/or emotional stress and not due to any underlying vascular pathologies (Butendieck and Murray, 2014). Raynaud phenomenon (RP) (secondary vasospasm) is also associated with episodic digit colour change due to vasospasm induced by cold or stress but occurs in patients secondary to an underlying diagnosis.…”