Pathophysiology

  • Cold/stress results in excessive vasoconstriction of the digital arteries 

   

Clinical features

  • Fingers turn pale or blue, with symptoms such as pain, numbness/tingling. Digits then turn red when they warm up.  
Raynaud's syndrome
Figure 173: Secondary Raynaud's in Sjögren's syndrome, Intermedichbo, CC BY-SA 3.0

Causes

  • Primary = Raynaud’s disease
  • Secondary = Raynaud’s phenomenon
    • Connective tissue disorders: Rheumatoid arthritis, SLE, systemic sclerosis, Sharp’s syndrome (MCTD)
    • Leukaemia
    • Type 1 cryoglobulinemia 

  

Management

  • 1st Line: calcium channel blockers (nifedipine)
  • 2nd line: IV Prostacyclin (epoprostenol infusions)