Raynaud's disease - a disease in which the arterial blood supply to the hands or feet is disturbed. The disease is paroxysmal in nature and usually affects symmetrically the upper limbs. Women get sick more often than men.
As a rule, Raynaud's syndrome is a secondary phenomenon that develops in various diffuse diseases of the connective tissue (primarily scleroderma), damage to the cervical spine, peripheral nervous system (gangliopitis), endocrine system (hyperthyroidism, diencephalic disorders), digital arteritis, arteriovenous aneurysm, aneurysm and aneurysm, and arteriovenous aneurysm, aneurysm and aneurysm of the cervical spine. neck ribs, with cryoglobulinemia.
If there are no specific reasons for the development of Raynaud's syndrome, then they speak of Raynaud's disease, its mandatory feature is the symmetry of the limb lesions.
Causes of Raynaud's Syndrome
Why does Raynaud's disease occur, and what is it? This disease was first described by the French physician Maurice Raynaud in 1862. He noticed that the hands of many women who daily had to wash their clothes in cold water had a bluish tint. Female workers complained of frequent numbness and unpleasant tingling in the fingers.
Raynaud concluded that prolonged cooling of the hands leads to a prolonged vasospasm and circulatory disorders. However, neither the French doctor nor his fellow followers managed to uncover the mechanism of the development of the disease.
However, there are factors that can contribute to the onset of the disease. These include:
- Endocrine disruption;
- Frequent stressful situations;
- Constant hypothermia of the extremities;
- Professional factors (such as vibration);
- Finger injuries;
- Any rheumatic diseases (these include rheumatoid arthritis, systemic lupus erythematosus, periarthritis nodosa and some other disorders);
- Autoimmune hemolytic anemia with complete cold antibodies.
- Hereditary factor.
The disease manifests itself periodically under the influence of provoking factors - negative emotions or low temperatures. Once a person goes out into the cold or is nervous, a spasm of small arterial blood vessels of the hands (less often - feet, ears, nose) occurs. The fingers turn white, a feeling of numbness, tingling, sometimes pain appears in them.
Symptoms of Raynaud's Disease
Depending on the stage of Raynaud's syndrome, the symptoms of the disease will progress (see photo):
- Angiospastic. There are short-term spasms of the vessels of the terminal phalanges of the fingers of the hands (usually the 2nd and 3rd), and more rarely - 1-3rd toes. Spasms are quickly replaced by dilation of blood vessels with reddening of the skin and warming of the fingers.
- Angioparalitichesky. It is characterized by frequent attacks that occur for no apparent reason and last for an hour or more. At the end of the attack, a phase of cyanosis develops - a blue-violet staining appears, followed by severe redness (reddening) and a slight swelling of the affected area.
- Trophoparalytic. Constantly increasing seizures with a long time spasm lead to the fact that the structure of the skin of the limbs is disturbed. On the fingers can form difficult healing ulcers and necrosis of the skin. Sometimes patients even start gangrene. This stage is called the trophoparalytic and is the most severe stage of Raynaud's disease.
In the case of Raynaud's disease, the earliest symptom is increased chilliness of the fingers - most often of the hands, to which the blanching of the terminal phalanges and pain in them with elements of paresthesia then join. These disorders are paroxysmal in nature and at the end of the attack disappear completely.
The distribution of peripheral vascular disorders does not have a strict pattern, but more often it is the II-III fingers of the hands and the first 2-3 fingers of the feet. Distal parts of the arms and legs are most involved in the process, much less often other parts of the body - ear lobes, nose tip.
The course of the disease is slowly progressive, but regardless of the stage of Raynaud's syndrome, there are cases of the reverse development of the process - with the onset of menopause, pregnancy, after childbirth, changes in climatic conditions.
Diagnosis of Raynaud's syndrome
In Raynaud's syndrome, the diagnosis is based mainly on the patient's complaints and objective data, as well as on additional research methods. During the diagnosis, a capillaroscopy of the patient's nail bed is performed. It allows visualization and study of functional and structural changes in the arteries of the limbs. Another stage in the diagnosis of Raynaud's disease is cold tests to assess the condition of the extremities after they are immersed in water with a temperature of 10 ° C for 2-3 minutes.
Also, in case of Raynaud's disease, the diagnosis includes an assessment of the following criteria:
- the level of circulatory disorders in the limbs,
- symmetry of sites with angiospasms,
- the presence of other phlebological diseases,
- the duration of symptoms of Raynaud's disease for at least 2 years.
Laboratory methods used in the diagnosis of Raynaud's syndrome:
- general blood analysis;
- blood chemistry;
- coagulogram (blood clotting parameters);
- immunological tests (immunity tests);
- general urine analysis.
The diagnosis of this disease is established using clear medical criteria. At the same time, attention is paid to vascular spasm, the occurrence of which occurs during the action of cold or stress, the symmetry of the symptoms of the disease and the recurrence of spasms, which is present for several years.
Raynaud's disease treatment
When symptoms of Raynaud's disease appear, the treatment can be divided into two groups - conservative and surgical.
- Conservative methods include the use of vasodilating drugs (for example, Phentolamine). Drug therapy for Raynaud's disease continues throughout the life of the patient. It should be noted that with long-term use of these drugs inevitably develop complications.
- When attacks of angiospasms of the extremities become insensitive to vasodilators, surgical treatment of Raynaud's disease - sympathectomy is recommended. It consists in removing or arresting the nerve fibers of the sympathetic trunk, causing spasms of the arteries. Endoscopic sympathectomy is considered the least traumatic surgical treatment of Raynaud's disease. During this procedure, a clip is placed on the sympathetic trunk in the chest or neck area under general anesthesia.
An important component of the treatment of Raynaud's disease is to limit the contact of the patient with provoking factors. When a high negative emotional stress should be taken sedatives. If necessary, contact with the cold and humid environment should be dressed warmer than usual, especially carefully insulate the hands and feet.
If the specialty implies a long or even short-term work on the street in any weather, you should raise the question of changing working conditions. The same applies to work related to constant nervous tension.
A new word in the treatment of Raynaud's syndrome is stem cell therapy aimed at normalizing peripheral blood flow. Stem cells contribute to the discovery of new collaterals in the vascular bed, stimulate the regeneration of damaged nerve cells, which ultimately leads to the cessation of vasoconstriction paroxysms.
In Raynaud's syndrome, the prognosis depends on the progression of the underlying pathology. The course of the syndrome is relatively favorable, attacks of ischemia can spontaneously cease after changes in habits, climate, profession, sanatorium treatment, etc.
To prevent an attack, you need to follow certain precautions, eliminating provoking factors:
- work related to the tension of the hands;
- contact with chemicals that are the root cause of vascular spasms.
When, after stress or hypothermia, the person feels numb of the fingertips and notice a change in the skin tone of the limbs, it is necessary to see a doctor. No need to self-medicate. A seemingly harmless pathology can lead to irreversible effects in the body.