Recent advances in the workup and management of Raynaud’s phenomenon

Abstract

oxide synthase 1 gene as significantly correlated with RP in the general population. 4 Major risk factors for primary RP include, in addition to the female sex and family history, a previous sensation of cold hands, migraine, cardiovascular diseases, decreased body mass index, manual occupation (not including vibration tool use), and estrogen replacement therapy. 3-6 Cigarette smoking and alcohol consumption are still of unclear significance when concerning the prevalence of primary RP. 7 Secondary RP associated with a known disease, mainly with systemic sclerosis (SSc) (>80% of patients) or other connective tissue diseases (CTDs), is rare and accounts for 10% to 20% of all RP cases. 8 Other common causes of secondary RP include diseases of arteries in the upper limbs (60% of RP occurring in individuals older than 60 years), malignancies, endocrine diseases, occupational syndromes, hematologic disorders, and infections (TABLE 1). 8,9 In addition, several Introduction Raynaud phenomenon (RP) is defined as recurrent, reversible episodes of vasospasm involving peripheral small vessels of the fingers and toes, at times also of the other acral sites (nose, ears, oral mucosa, lips, or nipples), when exposed to a cold environment or stressful situation. 1 This is characterized by a series of color changes in the affected area: first white (lack of blood flow), then bluish (deoxygenation of remaining blood), and red (reperfusion). Attacks can cause distal pain, burning, numbness, and paresthesia. 2 Regarding its etiology, RP is classified as primary (idiopathic) or secondary. Primary RP, which is an isolated finding without an underlying pathology, is common, occurring in about 5% of the general population living in areas with cold climates. 3 The prevalence of RP is higher in women (female-to-male ratio of 9 to 1). There is an associated genetic predisposition: one polymorphic variant was identified within the nitric

Raynaud's phenomenon

“…Drug treatment is indicated when non-pharmacological interventions are insufficient to manage RP and is often required in patients with SRP (especially SSc). 47 Calcium channel blockers (eg nifedipine) are often used as first-line drug treatment for PRP and SRP. 8,33,48,49 Other drug classes which are used for the treatment of RP include angiotensin receptor II antagonists (eg losartan), angiotensin-converting enzyme (ACE) inhibitors, and selective serotonin receptor antagonists (eg fluoxetine).…”

Raynaud’s Secondary to Granulomatosis With Polyangiitis

“…Sympathectomy and amputation are advised as the extreme option in cases of irreversible tissue necrosis. Digital periarterial sympathectomy and endoscopic thoracic sympathectomy can be done in patients with refractory digital ischemia and severe complications [ 16 ].…”

Low body weight and involuntary weight loss are associated with Raynaud’s phenomenon in both men and women

“…In line with this limitation, more specific assessment of CTD-specific data (including nailfold videocapillaroscopy) was not feasible at that point. Therefore, other approaches for the diagnosis of RP, as previously suggested by others, were not deemed possible (33,35,36,37) Furthermore, the self-reported nature of the CTD questionnaire might lead to an overestimation of the prevalence of RP. However, the CTD questionnaire used in the current study had been previously validated, and was found to have a high sensitivity and specificity for screening large populations (7).…”