Raynaud's Syndrome

Raynaud's syndrome is a functional circulatory disorder in which vessels in the fingers and toes contract like cramps. These spasms, also known as vasospasms, lead to a reduced blood supply in the affected areas. Raynaud's syndrome is often caused by stress or cold.

The risk of developing Raynaud's syndrome is five times higher for women than for men. The symptoms usually appear after puberty and improve until menopause. Raynaud's syndrome can be divided into 2 forms:

Primary Raynaud 's syndrome occurs idiopathically, so it is not known what causes are behind this form of the disease.

Secondary Ray naud's syndrome occurs as a result of other diseases, especially diseases with inflammatory changes in the vessel wall, such as scleroderma and lupus erythematosus. But also injuries or the excessive intake of certain drugs or toxic substances can trigger the secondary form.

The occurrence of Raynaud's syndrome is mainly associated with functional defects of vessels in the fingers and toes and with disorders of the nervous system. Hormonal changes also seem to contribute to the development of Raynaud's syndrome. However, it is not clear in what way these factors influence the disease.

The vascular spasms can also be triggered by other pre-existing diseases, such as scleroderma or rheumatism. Vibration caused by prolonged work with jackhammers or power saws can also trigger the symptoms.

In addition, Raynaud's syndrome can be caused by cold agglutinins: these are antibodies directed against erythrocytes that become active in cold temperatures and then trigger clumping (agglutination) of the blood. As a result, there is reduced blood supply to the toes and fingers due to blockage of the blood vessels.

Among the triggering factors of Raynaud's syndrome are medications, with a connection to ergotamine-containing preparations, cytostatics or nasal drops. However, the symptoms can also be caused by drugs.

Raynaud's syndrome is typically characterized by a white or blue discoloration of the skin on the fingers, toes, or rarely the nose or ears, which is usually accompanied by sensory disturbances and pain. In most cases, the vasospasms last no longer than 30 minutes, but in some cases they can last longer. After the attacks, the skin turns red due to excessive blood supply, and after prolonged vasospasms, there may be further defects in vessel walls and, subsequently, cell death.

If Raynaud's syndrome develops in the context of other diseases, additional changes may occur, especially in the skin or blood vessels. In scleroderma, for example, there is also swelling and tightening of the skin.

Raynaud's syndrome can usually be diagnosed on the basis of the symptoms. In cases of doubt, the cold provocation test can also be performed by holding the patient's hands in ice-cold water for a few minutes to trigger attacks. Another option is for the doctor to grasp the affected person's forearm, thereby reducing blood flow to the hand. After the patient then repeatedly closes the hand into a fist, the doctor releases the grip and examines how well the blood flow to the fingers is restored.

During the diagnosis, it is important to distinguish the primary form from the secondary form. Possible changes in the skin or the small blood vessels in the fingers and toes or certain blood parameters can be indicative of other underlying diseases and thus of the secondary form.

Although Raynaud's syndrome is often very unpleasant for those affected, there is no direct danger. A causal therapy is not possible, but there are many ways to reduce or even prevent the occurrence of attacks. For example, fingers and toes can be protected from the cold by wearing gloves, warm shoes or heat pads. Furthermore, one should refrain from smoking and pay attention to regular exercise and sports activities. Since psychologically stressful situations can also trigger Raynaud's syndrome, stress should be avoided or coping with it should be learned through relaxation exercises or alternative methods. If an attack is feared, the hands should be warmed with warm water and massaged, for example. This promotes the widening of the vessels and thus increases the blood supply. For the course of secondary Raynaud's syndrome, the recognition and treatment of the underlying disease is crucial. Rarely, in very severe manifestations of the disease, a severing of the supplying nerve can help.

A therapy with vasodilator drugs can also lead to an improvement of the symptoms:

- Pentoxiphylline

- Calcium antagonists

- ACE inhibitors (captopril)

- Prostaglandins (iloprost)

- diclofenac

The prognosis of primary Raynaud's syndrome is favorable, since there is usually no permanent damage to the vessels and death of the affected areas.

In the secondary form, however, the causative disease and its therapy are decisive for the course of Raynaud's syndrome. In the worst case, permanent vasospasms and cell death occur. In the worst case to the amputation of fingers.