Diseases > Raynaud’s Phenomenon (RP) > What is it?
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What is Raynaud’s?
Raynaud’s Phenomenon is a condition involving the circulation or blood flow. This usually involves the hands or feet although other parts of the body can be involved. In people with Raynaud’s, exposure to cold temperatures causes small blood vessels to “clamp down” or spasm (tighten up). This reduces the amount of blood flowing to the hands or feet, causing them to turn pale or white. Upon re-warming, the skin may turn another colour, usually blue or red, before turning back to normal. Attacks can last anywhere from a few minutes to a few hours or longer.
There are two basic types of Raynaud’s: primary Raynaud’s and secondary Raynaud’s. It is called secondary Raynaud’s because the Raynaud’s is “secondary” to another disease. It is seen secondary to other autoimmune diseases such as systemic sclerosis (scleroderma), lupus, rheumatoid arthritis, and Sjogren’s syndrome. Primary Raynaud’s happens by itself and there is no other underlying disease. Secondary Raynaud’s tends to be more severe than primary Raynaud’s and the symptoms can get worse over time.
What causes Raynaud’s?
Attacks of Raynaud’s are usually caused by exposure to cold temperatures. But other things can trigger an attack, too. For example, emotional stress, trauma (injury), hormonal changes and smoking can also trigger an attack. Previous injury to the extremities such as frostbite or surgery can make people more likely to develop Raynaud’s. So can repetitive actions or vibrations, such as using a jackhammer, drills, typing or piano playing.
At this time, we don’t fully understand what causes the blood vessels to become more sensitive to cold temperatures and other triggers. Some experts think it might be related to the immune system. That’s because Raynaud’s is sometimes associated with other autoimmune or connective tissue diseases such as rheumatoid arthritis and scleroderma.
Who gets Raynaud’s?
Raynaud’s Phenomenon primarily affects young women in their 20s or 30s. The condition appears to be more common in young women who are thin. Although no gene has been definitively linked to Raynaud’s, the disease often runs in families.
The second most common group of patients affected by Raynaud’s is people who have other underlying autoimmune diseases. Examples include lupus, inflammatory types of arthritis such as rheumatoid arthritis, Sjogren’s syndrome and scleroderma. It has been estimated that almost all people with scleroderma also have Raynaud’s, and that one in three people with Sjogren’s syndrome have Raynaud’s.
How is Raynaud’s diagnosed?
If you think you might have Raynaud’s, it is wise to go see your family doctor or a rheumatologist. A rheumatologist is a specialist in the field of arthritis and autoimmune diseases. The diagnosis of Raynaud’s is made by taking a careful history about the nature of the attacks. The most pertinent sign of Raynaud’s is the lack of blood flow to the fingers or the toes during an attack. This can be seen easily as the area affected will turn white, the red or blue then return to the natural colour of your skin.
What tests are done to diagnose Raynaud’s?
One of the best ways to test for Raynaud’s is to do what’s known as a cold challenge. The test is simple: you stick your hands under cold water. Individuals with Raynaud’s will lose circulation to their hands and fingers much more quickly than those not affected. There is also a more complicated procedure used in research called thermography which obtains the same result.
If you or your doctor thinks that you may have Raynaud’s, the following tests are recommended. First, a complete blood count should be performed; this gives your doctor information about the status of all of your blood cells. Your doctor will also look for markers of inflammation such as the erythrocyte sedimentation rate (ESR) and the level of C-reactive protein (CRP) in your blood. Other tests include the rheumatoid factor and antinuclear antibody (ANA). Testing for the thyroid stimulating hormone (TSH) is useful to rule out any thyroid conditions. Other more specific tests may be performed by a specialist. This is to investigate potential underlying autoimmune diseases that might accompany secondary Raynaud’s.
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