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[Changes in the parameters of respiratory function tests in Raynaud's disease].

Patients with Raynaud's phenomenon can demonstrate arterial spasm not only in hands but also in other organs. The aim of this study was to investigate pulmonary function in 15 patients with Raynaud's disease and in 8 healthy controls before and after cold pressor test. Before the cold pressor test no significant differences in pulmonary parameters between the patients and the controls were observed. After cold pressor test, a statistically significant decrease in diffusing capacity (DLCO) was observed in the study group, but not in the controls. Total lung capacity (TLC) was also slightly decreased. No significant changes of specific diffusing capacity (D/VA) and flow-volume curve parameters (FEF50, FEF25) were noticed.

Adult↗

Biofeedback treatment of Raynaud's disease and phenomenon.

Six Raynaud's disease and four Raynaud's phenomenon patients were treated with 12 sessions of finger temperature biofeedback. The mean frequency of vasospastic attacks was reduced to 7.5% of that reported during the pretreatment baseline and was maintained for a 1 year follow-up period. Significant control of digital temperature was demonstrated during laboratory training sessions. Raynaud's phenomenon patients showed significantly greater temperature increases during feedback periods than Raynaud's disease patients. Correlations between finger temperature and other physiological measures suggested that results could not be attributed to general physical relaxation. The role of imagery in self-control of digital temperature is considered.

Adult↗

Venodilation in Raynaud's disease.

The pathogenesis of Raynaud's disease is unclear; an enhanced response to catecholamines has been hypothesised to contribute to this vasospastic disorder. Impaired endothelium-dependent dilation occurs in other diseases associated with vasospasm, such as coronary atherosclerosis. We investigated both endothelium-dependent and endothelium-independent venodilatory function in Raynaud's disease using the hand-vein compliance technique. Full dose-response curves to noradrenaline were constructed in 10 subjects with primary Raynaud's disease and 10 age and sex matched control subjects. The two groups did not have a different response to noradrenaline. Mean (SD) log values of ED50s (the dose producing half maximum response) were 1.00 (0.59) (geometric mean 10 ng/min) in Raynaud's disease compared with 1.29 (0.66) (20 ng/min) in control subjects (p = 0.16). The efficacy of noradrenaline as a venoconstrictor was similar in the two groups: mean maximum dilation (Emax) to noradrenaline was 81 (14)% in the Raynaud's group and 89 (8)% in the control group (p = 0.08). Full dose-response curves to the endothelium-dependent dilator bradykinin were constructed. Emax to bradykinin was significantly lower in the Raynaud's group than in the control group (65 [21] vs 91 [29%], p = 0.02). ED50 values (doses producing half maximum response) for bradykinin were similar in the two groups. Maximum dilation with nitroprusside, a direct releaser of the vasodilator nitric oxide, was not diminished in the Raynaud's group (94 [23] vs 102 [15]% in controls, p = 0.26). These results suggest that endothelium-dependent venodilation is impaired in peripheral vessels in Raynaud's disease, possibly due to diminished release of nitric oxide, and may contribute to the pathogenesis of the disorder.

Angiotensin II↗

[Status of the mechanisms of autonomic regulation in Raynaud's disease].

Patients suffering from Raynaud's disease underwent clinicoelectrophysiological studies for the status of the segmental and autonomous nervous system. Based on the distribution of the patients' group with Raynaud's disease according to the type of the disease course and intensity of Raynaud's phenomenon, the author shows a relationship between the clinical manifestations of the leading phenomenon and disorders of sympathetic conduction in the limbs. That made it possible to suggest that peripheral vegetative neuropathy together with the well-defined psychovegetative syndrome may be implicated in the pathogenesis of Raynaud's disease.

Adult↗

Raynaud's phenomenon in mixed connective tissue disease.

Raynaud's phenomenon affects most patients who have mixed connective tissue disease (MCTD) and frequently represents the initial manifestation of the disease. It is the cutaneous symptom of a systemic vasculopathy that is characterized by intimal fibrosis and blood vessel obliteration that frequently leads to visceral involvement, particularly pulmonary hypertension. An association between Raynaud's phenomenon and the characteristic autoantibody in MCTD, anti-U1-RNP (ribonucleoprotein), is found across the spectrum of rheumatic diseases, including undifferentiated connective tissue disease, scleroderma, and systemic lupus erythematosus. Capillary nailfold examination represents a valuable tool to identify patients who are at risk for MCTD. The goal in the therapy of Raynaud's phenomenon in MCTD is to decrease the frequency of attacks, to prevent digital ulceration, and to limit progressive vascular damage. Therapeutic regimens include the traditional use of calcium channel blockers and novel vascular therapies.

Autoantibodies↗

[Raynaud's phenomenon. Practical considerations on the forms secondary to immunomediated systemic diseases].

Raynaud's phenomenon is a frequent asphyxial vascular syndrome interesting the 4% of general population. In most of cases it is a functional problem (Raynaud's disease). Less frequently it has an organic cause (Raynaud's syndrome). The pathogenesis of primitive Raynaud's phenomenon remains an enigma. In secondary Raynaud phenomenon the attacks of vasospasm can be explained by the physiopathologic events characterizing the underlying disease. For example, multiple cytokines, transforming grow factor beta, serum immunocomplexes are of great importance in the contest of connective diseases. Clinical examination, some usual laboratory and roentgenographic investigations and nailfold capillary microscopy are of particular importance in orientating the diagnosis.

Autoimmune Diseases↗

[Therapeutic effects of prolonged normovolemic hemodilution in patients with Raynaud's disease].

51 patients with Raynaud's disease has undergone prolonged normovolemic hemodilution (PNH) with a good effect. Disappearance of painful syndrome in 78.43% of cases, and a significant decrease of pains in 21.37% of cases was demonstrated. Complete healing of ulcero-necrotic defects of end phalanges of the hands was observed in 7 patients of 10 and partial--in 3. A significant remission of the disease in follow-up period was obtained. Thus, prolonged normovolemic hemodilution has resulted in significant improvement of short- and long-term results of treatment in patients with Raynaud's disease.

Adult↗