Raynaud's Phenomenon (Raynaud's disease)

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What is Raynaud's Phenomenon?

Raynaud's Phenomenon is a disease that is caused by involuntary narrowing of blood vessels most commonly in the regions supplying the fingers, toes, ears and tip of the nose. This can cause death of the tissue in those areas due to lack of blood supply. Raynaud's phenomenon causes distinct colour changes in the affected parts of the body and is usually brought on by certain triggers for example cold and emotional stress. Attacks generally last for minutes to hours and can vary. There are two main forms of Raynaud's phenomenon are divided into primary and secondary. The primary form of Raynaud's phenomenon is not associated with other diseases and is generally less severe, whereas the secondary form of Raynaud's phenomenon is associated with a group of conditions referred to as connective tissue disease and has worse consequences.

Who gets Raynaud's Phenomenon?

Raynaud's phenomenon can be associated with diseases of the arteries such as Buerger's disease and atherosclerosis, rheumatoid arthritis, scleroderma and systemic Lupus erythematosus. It can also follow repeated trauma, particularly vibrations such as those caused by typing or playing the piano. An overdose of ergot compounds or methysergide may also be a cause of Raynaud's phenomenon.

When Raynaud's phenomenon occurs without any underlying disorder, it is then known as Raynaud's disease. This is a common disease affecting 5% of the population and occurring predominantly in young women.

Predisposing Factors

The risk factors include:

Smoking

Working with vibrating machinery.

Emotional distress.

Exposure to the cold.

Women affected more often than men.

Causes of Raynaud's phenomenon

Primary or idiopathic Raynaud's phenomenon : Raynaud's disease
Secondary
- Collagen vascular diseases: scleroderma, systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis, polymyositis
- Arterial occlusive diseases: atherosclerosis of the extremities, thromboangiitis obliterans, acute arterial occlusion, thoracic outlet syndrome
- Pulmonary hypertension
- Neurologic disorders: intervertebral disc disease, syringomyelia, spinal cord tumors, stroke, poliomyelitis, carpal tunnel syndrome
- Blood dyscrasias: cold agglutinins, cryoglobulinemia, cryofibrinogenemia, myeloproliferative disorders,
  Waldenstrom's macroglobulinaemia
- Trauma: vibration injury, hammer hand syndrome, electric shock, cold injury, typing, piano playing
- Drugs: alpha-adrenergic receptor blockers, bleomycin, vinblastine, cisplatin

Progression

Over 90% of patients with Raynaud's phenomenon are female and, at the time of presentation, are often aged under 25. Up to 5% of patients initially presenting with only symptoms of Raynaud's eventually develop an autoimmune rheumatic disease.

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