Shrestha Sherry Chakraborty, Amity University Kolkata
Raynaud’s phenomenon or Raynaud’s syndrome is a condition characterized by vasospasm which is generally caused by excessive constriction of small arteries supplying blood to different body parts. This leads to a limited supply of blood and oxygen to the affected area. Low oxygen levels eventually cause necrosis of the affected tissue.
Symptoms are mostly characterized by numbness of the affected area along with changes in the colouration of the skin. Colour can be bright red or bluish-green, due to the lack of oxygen. It may lead to burns and loss of sensation in the affected area and these symptoms are often accompanied by pain.
FORMS OF RAYNAUD’S SYNDROME
Raynaud’s syndrome can often occur on its own and this form is called the primary form of the disease. When it is accompanied by another disease, it is then known as the secondary form of Raynaud’s syndrome. In such cases, it is mostly associated with connective tissue diseases like systemic lupus erythematosus.
Raynaud’s phenomenon is most prevalent in the female population, especially in younger females. Some anti-migraine drugs have shown to cause the secondary form of Raynaud’s syndrome. However, in older populations, obstructive pulmonary disease is a cause of Raynaud syndrome. The secondary form of Raynaud’s syndrome may also be associated with malignancy and infections like Hepatitis B and Hepatitis C.
MECHANISM OF RAYNAUD’S SYNDROME
The three main phenomena that occur in this disease are vasoconstriction, decreased blood flow to the affected area accompanied by immune responses, and inflammation. In the primary form of the disease, increased sensitivity of alpha-2 adrenergic in the digital and cutaneous blood vessels leads to vasoconstriction in response to low temperatures. Alpha-2 adrenergic receptors are present on the smooth muscles of the arteries of the digits. However, in the secondary form of the syndrome, the pre-existing disease prevents blood vessels from responding to temperature fluctuations. The endothelial properties of the digital and cutaneous blood vessels get disrupted, leading to subsequent constriction.
TREATMENT:
Treatment for Raynaud’s Syndrome mainly aims at the prevention of ischemia and reducing the severity of attacks. Lifestyle modifications such as refraining from cold and keeping warm as much as possible along with the reduction of emotional stress can play a very important part.
1. Calcium channel blockers are the first choice of drugs but it may lead to certain side effects like headaches and palpitations among many others.
2. Phosphodiesterase inhibitors – This is used when the patient fails to respond to or partially responds to calcium channel blockers.
3. Topical nitrates- nitroglycerine ointment in the affected areas is used but it has side effects such as dizziness and headaches.
4. Prostaglandins- It is administered when there are symptoms of ischemia and it also prevents the accumulation of platelets.
The response of a patient to treatment is generally assessed based on the ‘Raynaud Condition Score’, which generally focuses on the severity of attacks, the quality of life before and after medications, and the overall effect of the syndrome on the person.
Thus, these are the different ways by which Raynaud’s Syndrome can be treated and managed to lead a more manageable and peaceful life.
Also read: Tumorigenic Transformation of Stem Cells can cause Cancers
Source:
1. Musa R, Qurie A, . Raynaud Disease (Raynaud Phenomenon, Raynaud Syndrome 2020,.
https://www.ncbi.nlm.nih.gov/books/NBK499833/?report=printable
2. Ventura I, Reid P, Jan R. Approach to Patients with Suspected Rheumatic Disease. Prim. Care. 2018 Jun;45(2):169-180. [PubMed: 29759118].
3. Picture Credit: https://www.hopkinsmedicine.org/health/conditions-and-diseases/raynauds-phenomenon
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