ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. I73M34ArtikelübersichtRaynaud syndrome
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
Raynaud's syndrome: description
Raynaud syndrome is a vascular disease caused by vascular spasm (vasospasm). The convulsions occur as an attack mostly on the fingers, more rarely on the toes and other parts of the body. This reduces the blood supply to the affected body region - they are pale and cold, which is why one speaks of a corpse finger or Weißfingerkrankheit-. The cramps are usually triggered by cold and psychological stress.
The syndrome was first described in 1862 by medical student Maurice Raynaud. Physicians distinguish today two forms of Raynaud's syndrome: in the first, the cause is unknown (primary Raynaud's syndrome). The second form occurs in the context of other diseases (secondary Raynaud's syndrome), for example, scleroderma (a hereditary disease of the connective tissue), after injuries or overdose of certain drugs.
The primary Raynaud's syndrome is especially affecting women between the ages of 20 and 40 years. Overall, women are affected about five times more frequently than men. An estimated three percent of the population has the typical symptoms of Raynaud's primary syndrome.To the table of contents
Raynaud's syndrome: symptoms
Typical of the Raynaud's syndrome is that fingers (with the exception of the thumb) or the toes due to the disturbed blood supply seizure initially pale and later blue. Those affected suffer from sensations of smell, numbness and sometimes also pain. The attacks usually last no longer than half an hour, but can last longer. Afterwards the skin is often reddened. These Raynaud's syndrome symptoms are known as tricolor phenomena.
In a primary Raynaud syndrome, the symptoms occur on both hands or feet. In a secondary Raynaud syndrome, usually only one side is affected.
If the cramps (spasms) persist for a longer period of time, the vessels are permanently damaged. Then the tissue can die off - necroses form. However, such damage usually only occurs as complications of secondary Raynaud's syndrome.
If the Raynaud syndrome is the result of scleroderma (hereditary connective tissue disease), then the skin of the hands, arms or face is thickened and taut. In addition, the blood vessels in the affected area are changed.To the table of contents
Raynaud's syndrome: causes and risk factors
A Raynaud's syndrome is caused by very strong and sudden narrowing of the vessels (especially in the fingers and hands), which resolve after some time. This is called vasospasm. The seizures occur especially in cold temperatures and under stress. The cause of this phenomenon is an imbalance of vasodilator and vasoconstrictor factors.
The vascular spasms of Raynaud's syndrome can be caused by disorders of the blood vessels in the toes and fingers or by a disturbed nerve activity. Also disturbances in the hormone balance can play a role. How these different factors interact is still unclear.
The causes of the primary Raynaud's syndrome are still largely unknown. Especially young women are affected. In the course of life, the attacks are usually increasingly rare and weaker. Frequently, the primary Raynaud's syndrome is more common in the family. Above all, smoking favors the development of Raynaud's syndrome.
A secondary Raynaud's syndrome can be triggered by a variety of different diseases. These include rheumatological diseases, but also disorders of the nerves (for example, multiple sclerosis) or vascular diseases such as arteriosclerosis. Also cancers, especially of the hematopoietic system, can cause Raynaud's syndrome.
Sometimes a carpal tunnel syndrome, in which certain nerve tracts are trapped in the wrist, is associated with the Raynaud's syndrome. Scleroderma, an autoimmune disease that leads to hardening of connective tissue in the skin, often results in Raynaud's syndrome. In the context of autoimmune diseases, so-called cold agglutinins can be detected in the blood. Cold agglutinins are antibodies that clump when cold. The body responds with inflammatory reactions, which in turn promote vasoconstriction and thus promote a Raynaud's syndrome.
Some medications (contraceptives, cytostatics, interferon, beta-blockers, ergotamine and dopaminergic drugs) or drugs (cocaine, designer drugs) can cause Renauld syndrome. Some people who come into contact with certain chemicals in their profession (for example, polyvinyl chloride) or work longer with vibrating machines such as jackhammer or chainsaw, also develop a Raynaud's syndrome.To the table of contents
Raynaud's syndrome: examinations and diagnosis
The first point of contact for a Raynaud's syndrome is the family doctor, who may refer you to a rheumatologist. As a rule, a detailed description of the symptoms is sufficient to make the diagnosis "Raynaud's syndrome".
The medical consultation provides important information on the type and cause of Raynaud's syndrome. In conversation, the doctor will ask questions such as:
- Do you notice sudden discoloration of your hands, possibly associated with pain?
- Do the symptoms appear symmetrically on both hands?
- Do the symptoms often occur under stress or cold?
- Have you noticed any changes to your hands?
- Do you have known pre-existing conditions?
- Do you know similar cases in your family?
A series of tests can confirm the diagnosis of Raynaud's syndrome. For example, the fistula test can be used to check the blood flow into the fingers in the side comparison. For this purpose, the doctor firmly encloses the patient's wrist and lets him close and reopen the fist about 20 times. If there is a Raynaud syndrome, the fingers in this experiment usually bass.
The Allen test is used to examine the arteries that conduct blood into the hand. The surgeon presses one of the two arteries (A. radialis or A. ulnaris) one after the other and checks whether the open artery supplies the hand with sufficient blood. If the hand becomes pale during compression, the uncompressed artery is probably closed.
A cold provocation test can determine if cold can be the trigger of an attack. For this, the hands are dipped in ice water for about three minutes. However, this investigation is controversial, since the attacks can not be reliably triggered.
Another important factor in suspecting Raynaud syndrome is the inspection of the hands. The doctor pays attention to wounds and tissue damage such as dead areas on the fingertips, so-called rat bite or fingertip necrosis. In addition, the doctor is looking for changes on the nail.
Diagnosis of a primary Raynaud's syndrome
The criteria for the diagnosis of a primary Raynaud's syndrome are:
- Both hands are affected.
- The attacks are mainly in cold or stress.
- There are tissue damage.
- The symptoms have been occurring for more than two years without an underlying disease being detected.
- Further investigations are inconspicuous.
In addition, for a primary form of Raynaud's syndrome, if the sufferer is young (under 30) and female, or if she also has migraine or a special form of heart ganglene (Prinzmetal's angina), both diseases are caused by cramping of certain blood vessels.