Raynaud's disease 725224 225770941 2008-07-15T09:27:12Z Chaldor 7312839 /* External links */ deleted some external links {{Infobox Disease | Name = Raynaud's disease | ICD10 = {{ICD10|I|73|0|i|70}} | ICD9 = {{ICD9|443.0}} | DiseasesDB = 11186 | OMIM = 179600 | eMedicineSubj = med | eMedicineTopic = 1993 | MedlinePlus = 000412 | MeshName = Raynaud | MeshNumber = C14.907.744 | }} '''Raynaud's disease''' (RAY-noz) is a vascular disorder<ref>{{Dorlands|d_22|12305108}}</ref> that affects [[blood]] flow to the extremities which include the [[finger]]s, [[toes]], [[nose]] and [[ears]] when exposed to temperature changes or stress. It was named after [[Maurice Raynaud]] ([[1834]] - [[1881]]),<ref>{{WhoNamedIt|synd|2958|Raynaud's disease}}</ref> a French physician who first described it in [[1862]].<ref>{{cite journal |author=Raynaud AGM. |title=De l'asphyxie locale et de la gangrène symétrique des extrémités |journal=Academic thesis, Paris, Rignoux |date=1862}}</ref> ==Symptoms== <gallery> [[Image:1130071845.jpeg|Caption1 </gallery> [[Image:Raynaud-hand2.jpg|right|thumb|Hands with Raynaud's disease]] The symptoms include several cyclic color changes: # When exposed to cold temperatures, the [[blood]] supply to the fingertips, toes, nose, and earlobes of Raynaud's disease patients is reduced and the skin turns pale or '''white''' (called [[pallor]]) and becomes cold and numb. # When the [[oxygen]] supply is depleted, the skin colour turns '''blue''' (called [[cyanosis]]). # These events are episodic and when the episode subsides, or the area is warmed, blood returns to the area and the skin colour turns '''red''' ([[rubor]]) and then back to '''normal''', often accompanied by [[Swelling (medical)|swelling]] and [[tingling]]. These symptoms are thought to be due to reactive [[hyperemia]]s of the areas deprived of blood flow. All three colour changes are present in classic Raynaud's disease. However, some patients do not see all of the colour changes in all outbreaks of this condition. ==Disease vs. phenomenon== It is important to distinguish ''Raynaud's disease'' from [[Raynaud's phenomenon]]. In order to diagnose these two forms of Raynaud, your doctor may look for signs of [[arthritis]] or [[vasculitis]] and conduct a number of [[medical laboratory|laboratory]] tests. ===Primary Raynaud's (disease)=== Raynaud's disease (or "Primary Raynaud's") is diagnosed if the symptoms occur only by themselves and are not accompanied by other diseases. Primary Raynaud's often develops in young women in their teens and young adulthood. This form of Raynaud's is thought to be at least partly hereditary, although specific genes have not yet been identified.<ref name="pmid16609626">{{cite journal |author=Pistorius MA, Planchon B, Schott JJ, Lemarec H |title=[Heredity and genetic aspects of Raynaud's disease] |language=French |journal=J Mal Vasc |volume=31 |issue=1 |pages=10–5 |year=2006 |pmid=16609626 |doi= |url=http://www.masson.fr/masson/MDOI-JMV-01-2006-31-1-0398-0499-101019-200517601}}</ref> ===Secondary Raynaud's (phenomenon)=== Raynaud's phenomenon (or "Secondary Raynaud's") occurs secondary to many different causes: * The most common causes are [[connective tissue disorder]]s such as [[lupus erythematosus|systemic lupus erythematosus]], [[Scleroderma|scleroderma/systemic sclerosis/CREST syndrome]], [[arthritis]] and many others. * Other disorders that can be causes include [[carpal tunnel syndrome]] and [[obstructive arterial disease]]. * Medications that can be causes include [[beta-blockers]] and [[ergotamine]]. In contrast to the ''disease'' form, this form of Raynaud can progress to [[necrosis]] or [[gangrene]] of the fingertips. Patients with secondary RP can also have symptoms related to their underlying diseases. RP is the initial symptom of 70% of patients with scleroderma, a skin and joint disease. Other rheumatic diseases frequently associated with RP include systemic lupus erythematosus, rheumatoid arthritis, and Sjogren's syndrome. For further information, please read the [[Scleroderma]], [[Systemic Lupus Erythematosus]], and [[Rheumatoid Arthritis]] articles. ==Prevention== Patients with Raynaud's disease are advised to keep warm by wearing [[gloves]] and socks. They should also avoid stress, medicines that can constrict blood vessels such as [[decongestant]]s and touching cold objects. Patients are also advised to avoid foods and activities that may constrict blood vessels such as drinking caffeinated drinks and smoking. Avoiding artificially cold environments, such as refrigerated or highly air conditioned spaces, can also help prevent episodes from occurring. ==Pathophysiology== Raynaud disease is an exaggeration of [[vasomotor]] responses to cold or emotional stress. More specifically, it is a hyperactivation of the [[sympathetic system]] causing extreme [[vasoconstriction]] of the peripheral blood vessels, leading to tissue [[hypoxia]]. Chronic, recurrent cases of Raynaud phenomenon can result in atrophy of the [[skin]], [[subcutaneous tissue]]s, and [[muscle]]. It can also rarely cause [[ulcer]]ation and [[ischemic gangrene]].<ref name=robbins>{{cite book|title= Robbins & Cotran Pathologic Basis of Desease|last= Kumar|first= Vinay|coauthors= Nelso Fausto, Abul Abbas|year= 2004|publisher= Saunders|isbn= 0721601871|pages=542 }}</ref> ==Treatment== {{seealso|Raynaud's phenomenon#Treatment}} The severity of the disease runs from mild to severe. In people with mild cases, this may be simply an annoyance. Heatbands and [[hand warmers]] may be used on the wrists to warm the blood flowing to the hands. More serious cases require medical intervention due to the risks of [[gangrene]] and possible digital [[amputation]]. [[Microvascular surgery]] of the affected areas is a possible therapy. Treatment for Raynaud's disease may include prescription medicines that dilate blood vessels, such as [[calcium channel blocker]]s ([[nifedipine]]). Mild cases of Raynaud's can be addressed by [[biofeedback]] or a technique to help control involuntary body functions such as skin temperature. In severe cases, a [[sympathectomy]] procedure can be performed. Here, the nerves that signal the blood vessels of the fingertips to constrict are surgically cut. ==Footnotes== {{reflist|2}} ==See also== *[[Raynaud's phenomenon]] *[[CREST syndrome]] *[[Vasospasm]] ==External links== *[http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/raynauds_disease.jsp Raynaud's Disease] at healthatoz.com *[http://www.nhlbi.nih.gov/health/dci/Diseases/raynaud/ray_what.html What Is Raynaud's Disease] at [[National Heart, Lung, and Blood Institute]] *[http://www.mayoclinic.com/invoke.cfm?id=DS00433 Raynaud's Disease] at [[Mayo Clinic]] *[http://www.niams.nih.gov/hi/topics/raynaud/ar125fs.htm Raynaud's Phenomenon] at [[National Institute of Arthritis and Musculoskeletal and Skin Diseases]] <!--- Three videos? Do we really need three videos? Just work one of them into the page ---> *{{YouTube|gHYskEqj8Tc|Raynaud's Disease}} *{{YouTube|5b7_DZOxHzc}} *{{YouTube|nRtNY6x1LAY|Raynaud's Phenomenon}} {{Vascular diseases}} [[Category:Cardiovascular diseases]] [[Category:Syndromes]] [[Category:Rheumatology]] [[de:Raynaud-Syndrom]] [[es:Enfermedad de Raynaud]] [[fr:Maladie de Raynaud]] [[pl:Choroba Raynauda]] [[pt:Doença de Raynaud]]