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International Angiology 2016 April;35(2):117-21

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Raynaud’s Syndrome: a neglected disease

Pavel POREDOS ¹, Peter POREDOS ² ✉

¹ Department of Vascular diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia; ² Department of Anaesthesiology and Perioperative Intensive Medicine, University Medical Centre Ljubljana, Ljubljana, Sovenia

Raynaud’s Syndrome is a frequent manifestation of digital ischemia which occurs or is aggravated upon exposure to cold temperatures or emotional distress. Primary Raynaud is a benign disease which predominantly affects younger women and is transient without serious sequelae. In contrast, secondary Raynaud is usually one of the manifestations of systemic disease and is, in addition to symptoms of the basic disease, associated with ischemic lesions. The diagnosis of primary Raynaud is mostly based on the clinical presentation. In secondary Raynaud, additional investigating techniques including imaging investigations and laboratory tests for the detection of underline disease are needed. Treatment is based on lifestyle modification, which includes smoking cessation, avoiding low outside temperatures, avoiding the use of vibrating tools and limiting repeated hand actions. Drug treatment consists of calcium-channel blockers, nitroglycerine ointments, prostacyclins and various new drugs such as endothelin receptor antagonists, phosphodiesterase inhibitors and serotonin receptor antagonists. Most of these drugs are effective in less than 50% of treated patients and do not completely abolish vasospastic attacks, but reduce the severity and frequency of attacks. The prostacyclin derivate iloprost is the most promising drug in the management of secondary Raynaud’s disease. Other therapeutic procedures including chemical or surgical sympathectomy are obsolete and without any long-term positive effects.