Remission of Raynaud’s phenomenon after L-thyroxine therapy in a patient with hypothyroidism

Abstract

A 50-year-old man is described who had a 15-year history of Raynaud's phenomenon with severe and frequent vasospastic attacks in his fingers and toes during the past years. Exacerbation of his digital symptoms, which started about 4 years ago, was accompanied by signs of thyroid deficiency, such as tiredness, memory impairment, decreased libido, constipation, dryness of skin and bradycardia. Hormonal evaluation revealed primary hypothyroidism and the patient began substitution therapy with L-thyroxine. After 2 months of treatment not only did he become euthyroid but the digital symptoms also disappeared. The patient may thus represent one of the very few cases whose thyroid replacement therapy proved to be highly effective in treating both hypothyroidism and Raynaud's phenomenon.

Dry skin conditions are related to the recovery rate of skin temperature after cold stress rather than to blood flow

“…These differences of TEWL in the summer may affect the deterioration of skin dryness in the winter. The skin blood flow functionality measured by CST may be involved in skin homeostasis during the 19,20 In addition to healthy subjects, an impaired RR is possibly involved in the dry skin symptoms of patients with these diseases.…”

“…Despite the fact that no difference of the visual dryness score was observed between the high RR and the low RR groups in the summer, the TEWL was slightly higher in the low RR group (P < 0.1). 19,20 In addition to healthy subjects, an impaired RR is possibly involved in the dry skin symptoms of patients with these diseases.…”

“…17 Although environmental factors such as low temperature and humidity are causes of dry skin, 18 it remains unclear why the degree of dry skin varies in different individuals. Given that previous reports showed that patients with Raynaud's phenomenon or diabetes often present with dry skin, 19,20 we hypothesized that cutaneous blood flow, particularly the sensitivity to a cold environment, is related to dry skin conditions in the winter even in healthy adults. Few studies have assessed the relationship between blood flow and skin physiology, including dry skin.…”

Clinical and subclinical autoimmune thyroid disorders in systemic sclerosis

“…The diagnosis of thyroid dysfunction in SSc may have an important impact also on the clinical manifestations of SSc; in fact, Raynaud's phenomenon is more difficult to control in hypothyroid individuals (44,45), and pulmonary hypertension (46) can be seriously influenced by hemodynamic changes of hypothyroidism. Thyroid function and ultrasonography should be tested as a part of the clinical profiling of SSc patients.…”

The relationship between Raynaud’s phenomenon and Helicobacter pylori

“…Previous literatures reported that the pathophysiology of RP is complex and multifactorial, involving the endothelium, neuroreceptor expression, and locally produced mediators that affect vascular responses (2,3). Additionally, especially for the etiology of SRP, some different clinical disorders like hypothyroidism with high thyroid-stimulating hormone levels (4) or vascular toxicity associated with anti-neoplastic agents (5) or some rheumatic diseases like systemic lupus erythematosus, Sjogren's syndrome and scleroderma (2) were also considered re-sponsible for Raynaud's symptoms. Likewise, according to previous literature (6,7), Helicobacter Pylori (HP) can be a possible factor leading to RP.…”