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Raynaud's phenomenon - Management
Underlying causes of, or diseases associated with, secondary Raynaud's phenomenon
- Connective tissue diseases:
- Systemic sclerosis/scleroderma.
- This includes CREST (Calcinosis, Raynaud's phenomenon, Esophageal dysfunction, Sclerodactyly, and Telangiectasia) syndrome, which is now more usually termed 'limited cutaneous systemic sclerosis'.
- Systemic lupus erythematosus.
- Rheumatoid arthritis.
- Sjogren's syndrome.
- Vasculitis (giant cell arteritis, Takayasu's arteritis, malnutrition).
- Mixed or undifferentiated connective-tissue disease.
- Dermatomyositis and polymyositis.
- Vascular occlusive diseases:
- Buerger's disease (thromboangiitis obliterans).
- Arteriosclerosis.
- Thromboembolic disease.
- Drugs:
- Amphetamines and cocaine.
- Beta-blockers.
- Angiotensin-converting enzyme (ACE) inhibitors.
- Cancer chemotherapy (bleomycin, cisplatin, and vinblastine).
- Ciclosporin.
- Ergots/ergot derivatives (ergotamine, methysergide, bromocriptine, cabergoline, pergolide).
- Interferon alpha and beta.
- Combined oral contraceptives.
- Sumatriptan.
- Clonidine.
- Haematological:
- Polycythaemia.
- Monoclonal gammopathies.
- Paraproteinaemia.
- Leukaemia.
- Cryoglobulinaemia.
- Cold agglutinin disease.
- Protein C, protein S, or antithrombin III deficiency.
- Factor V Leiden.
- Occupational/environmental:
- Vibration injury leading to vibration white finger (now referred to as 'hand–arm vibration syndrome').
- Exposure to vinyl polychloride.
- Frostbite/cold injury.
- Ulnar aneurysm (hypothenar hammer syndrome).
- Anatomical:
- Thoracic outlet syndrome (caused by compression from a cervical rib or scalenus anterior muscle).
- Carpal tunnel syndrome.
- Infectious:
- Hepatitis B and C (associated with cryoglobulinaemia).
- Mycoplasma infections (cold agglutinins).
- Parvovirus B19.
- Endocrine:
- Hypothyroidism.
- Phaechromocytoma.
- Carcinoid syndrome.
[Klippel, 2003; Gayraud, 2007; Pope, 2007b; Bakst et al, 2008]
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