Raynaud's disease

General characteristic of a disease

Raynaud's disease or Reynaud's phenomenon – one of rare diseases of arteries of extremities. It is shown in vasospastic (spontaneous) reduction of walls of vessels. As a result of it at the person the bloodless site – ischemia is formed. The long vasomotor spasm of arteries leads to change of a color of tissues of extremity – one of the main symptoms of a Raynaud's disease.

The Raynaud's disease is localized, as a rule, on feet or brushes of the person. Damage of arteries usually bilateral symmetric. Carry to the risk factors provoking a Raynaud's disease frequent cases of a hypothermia (overcooling of the lower extremities), injuries, systematic intensive load of extremities, and also endocrine disturbances and a heavy emotional stress. Raynaud's diseases are subject to a thicket women up to 40 years. The disease quite often occurs at the people suffering from migraines.

The Raynaud's disease should be distinguished from Reynaud's syndrome. Development of a vasomotor spasm of extremities against the background of a chronic scleroderma and other pathologies of connecting fabric indicates Reynaud's syndrome. It differs in later manifestation of symptoms, asymmetry of manifestation of vasomotor spasms and an obligatory combined current with other vascular or autoimmune disease from a Raynaud's disease.

Raynaud's disease symptoms

In a course of a disease of Reynaud it is accepted to allocate 3 stages with characteristic symptoms of a disease. Symptoms of a Raynaud's disease of the first stage is essential increase in a tone of walls of vessels. The hyper tone leads to a short-term spasm of arteries, blanching of integuments and an acute pain – to several more important symptoms of a Raynaud's disease at this stage. After a short-term attack pain passes, and the color of extremities becomes natural again.

At the second stage of a Raynaud's disease cyanosis, marble coloring of skin, puffiness of extremities joins symptoms of the first stage pronounced. This stage of a disease is also followed by a megalgia during an attack. The first two stages of a Raynaud's disease can develop up to 3-5 years.

Symptom of a Raynaud's disease of the third stage – emergence on extremities of sites of nekrotichny fabric. Because of disturbances of blood supply of extremities of a wound on them badly heal. At this time accession of consecutive infection, and also development of sepsis is possible.

Diagnosis of a Raynaud's disease

Diagnosis of a Raynaud's disease includes assessment of the following criteria:

• level of disturbance of blood circulation in extremities,
• symmetry of sites with vasomotor spasms,
• existence of other flebologichesky diseases,
• duration of manifestation of symptoms of a Raynaud's disease not less than 2 years.

During diagnosis of a Raynaud's disease the kapillyaroskopiya of a nail bed of the patient is carried out. She allows to visualize and study functional and structural changes in arteries of extremities.

One more stage of diagnosis of a Raynaud's disease – cold tests for assessment of a condition of extremities after their immersion in water with a temperature of 10 °C at 2-3 minutes.

Differential diagnosis of a Raynaud's disease assumes an exception about 70 autoimmune and flebologichesky diseases which can be followed by Reynaud's syndrome.

Treatment of a Raynaud's disease

At the diagnosis "Reynaud's syndrome" the main efforts are directed to therapy of a basic disease. Treatment of a Raynaud's disease is done in other direction, namely in stopping of symptoms of a disease and prevention of the reasons causing disease attacks.

At the first stage of a Raynaud's disease treatment exclusively conservative. The vasomotor spasm attack easily is removed by means of warm trays, wrapping, massage of the sick site of an extremity. Drug treatment of a Raynaud's disease consists in reception of vasodilating drugs. The patient is recommended to exclude probability of overcooling, injuries of an extremity and not to worry whenever possible.

Local wound healing therapy is appointed to stages of emergence of ulcers and a necrosis of fabrics to the patient. Drug treatment of a Raynaud's disease can continue several years, up to the period when attacks of vasomotor spasms of extremities become not sensitive to vasodilating drugs.

In this case already surgical treatment of a Raynaud's disease - a sympathectomy is recommended. It consists at a distance or stopping of the nerve fibrils of a sympathetic trunk causing spasms of arteries. The endoscopic sympathectomy is considered the least traumatic type of surgical treatment of a Raynaud's disease. During it to the patient under the general anesthesia the clip on a sympathetic trunk in a breast or a neck is imposed.

Auxiliary method of treatment of a Raynaud's disease – plasma exchange sessions for removal from blood of the patient of all harmful toxic and metabolic components.