Raynaud’s syndrome (RS) is a vasospastic disorder with potential hereditary predisposition and multiple triggering factors. After the exclusion of external stimuli and local disorders, autoimmunity presents a potenti...Raynaud’s syndrome (RS) is a vasospastic disorder with potential hereditary predisposition and multiple triggering factors. After the exclusion of external stimuli and local disorders, autoimmunity presents a potential intrinsic trigger even in idiopathic RS. We present a 47-year-old woman with severe and progressive RS in both hands and toes for 2 years. She did not have: a) clinical and laboratory evidence of systemic autoimmune diseases;b) prior drug exposure;c) local digits disease. She could not tolerate vasodilators. Since she had elevated C-reactive protein, she received MMF as immunosuppressive therapy. Within 2 weeks, her symptoms improved, and she remained disease-free for 2 years. In conclusion, blocking intrinsic autoimmune triggers with MMF is a safe, practical, and effective short- and long-term treatment for refractory primary RS.展开更多
Raynaud’s phenomenon is a symptom complex manifested as intermittent fingertip ischemia caused by cold or other sympathetic drivers.Secondary Raynaud’s phenomenon is often more severe and could even lead to finger u...Raynaud’s phenomenon is a symptom complex manifested as intermittent fingertip ischemia caused by cold or other sympathetic drivers.Secondary Raynaud’s phenomenon is often more severe and could even lead to finger ulceration,making it particularly complicated to treat.We describe a case of severe Raynaud’s phenomenon secondary to subclinical hypothyroidism lasting for more than 6 hours in a 65-year-old woman.The patient was also diagnosed with hypothyroidism,epilepsy,and secondary soft tissue infection of the right middle and ring fingers.After careful multidisciplinary consultation and discussion,the patient received vasodilation,anticoagulation,thyroxine supplementation,stellate ganglion block,hyperbaric oxygen therapy and debridement.The patient responded well to the medication,avoiding amputation or obviously dysfunction.Multidisciplinary team gathering the doctors from different departments proposes appropriate strategies for patients with severe Raynaud’s phenomenon and could improve the prognosis and satisfaction of patient effectively.展开更多
文摘Raynaud’s syndrome (RS) is a vasospastic disorder with potential hereditary predisposition and multiple triggering factors. After the exclusion of external stimuli and local disorders, autoimmunity presents a potential intrinsic trigger even in idiopathic RS. We present a 47-year-old woman with severe and progressive RS in both hands and toes for 2 years. She did not have: a) clinical and laboratory evidence of systemic autoimmune diseases;b) prior drug exposure;c) local digits disease. She could not tolerate vasodilators. Since she had elevated C-reactive protein, she received MMF as immunosuppressive therapy. Within 2 weeks, her symptoms improved, and she remained disease-free for 2 years. In conclusion, blocking intrinsic autoimmune triggers with MMF is a safe, practical, and effective short- and long-term treatment for refractory primary RS.
文摘Raynaud’s phenomenon is a symptom complex manifested as intermittent fingertip ischemia caused by cold or other sympathetic drivers.Secondary Raynaud’s phenomenon is often more severe and could even lead to finger ulceration,making it particularly complicated to treat.We describe a case of severe Raynaud’s phenomenon secondary to subclinical hypothyroidism lasting for more than 6 hours in a 65-year-old woman.The patient was also diagnosed with hypothyroidism,epilepsy,and secondary soft tissue infection of the right middle and ring fingers.After careful multidisciplinary consultation and discussion,the patient received vasodilation,anticoagulation,thyroxine supplementation,stellate ganglion block,hyperbaric oxygen therapy and debridement.The patient responded well to the medication,avoiding amputation or obviously dysfunction.Multidisciplinary team gathering the doctors from different departments proposes appropriate strategies for patients with severe Raynaud’s phenomenon and could improve the prognosis and satisfaction of patient effectively.
