Raynauds Phenomenon - Essay Example

Running Head: Raynaud’s Phenomenon Raynaud’s Phenomenon inserts his/her Raynaud’s phenomenon d after a French physician Maurice Raynaud, Raynaud’s phenomenon is a vasospastic disorder, affecting blood vessels of fingers, toes, ears and nose. It has a primary form where this condition is classified as idiopathic, and a secondary form that results from certain stimulants, like cold and stress and may be associated with another underlying disease. Sometimes this condition can accompany another disorder for instance lupus and scleroderma.

The primary type may proceed into secondary which may in severe cases culminate in gangrene and necrosis. Raynaud’s phenomenon is thought to result from over activation of the sympathetic system, which is characterized by vasoconstriction leading to a state of lack of oxygen in the tissues. In a patient with Raynaud’s phenomenon, there may be three skin color changes; at first the skin may undergo pallor which is primarily due to constriction of arteries (Spencer, 1998). This may be followed by cyanosis which is blueness of the tissues due to hypoxia, with the final change settling in as rubor that is redness due to return of blood into the arteries of the affected parts.

However, it is not obligatory that all patients have a triphasic change of colors. In fact, it is now believed that most patients present only with bluish discoloration of digits, which is known as acrocyanosis (Sharathkumar, 2011). However, some groups of thoughts negate the idea, they believe that acrocyanosis is distinct from Raynaud’s phenomenon since it is characterized by continuous cyanosis (Wigley, 2002). Raynaud’s phenomenon in infants is a rare finding. One such finding was relegated by a research paper consisting of a case report regarding an infant presenting with unilateral cyanosis at 1 month of age, who was later diagnosed to have primary Raynaud’s phenomenon at 9 months of age (Sharathkumar, 2011).

In this particular event, presence of unilateral acrocyanosis was an atypical finding which made the allowance to include Raynaud’s Phenomenon as one of the differential diagnosis. Its Pathophysiology is related to an imbalance between vasoconstrictors and vasodilators. Primary form of this condition is mild in behavior but the secondary form is more aggressive and morbid. Since it is challenging to predict which subset of patients is more likely to be diagnosed with the secondary form, one factor that can assist in determination of secondary Raynaud’s phenomenon in children is the presence of changes in the nail fold capillaries, as put forward by Sharathkumar and colleagues.

They suggest that observation of the microvasculature of nail fold with a videocapillaroscopy is a tool for suspecting secondary Raynaud’s in ambiguous cases. In cases, where there are giant capillaries and evidence of avascularity along with changes of incongruity in the architecture of the capillaries, there is a higher possibility of development of secondary form. The case report highlighted some important aspects of Raynaud’s phenomenon in children. It established that diagnosis of primary Raynaud’s is often delayed in younger individuals, subsequently leading to a delay in clinical intervention.

It also discussed in meticulous detail the pathophysiology and clinical tools for identifying Raynaud’s phenomenon at an earlier stage. However, in all cases close clinical monitoring is essential for accurate diagnosis. References: Anjali A. Sharathkumar, Paul Castillo-Caro. Primary Raynaud's phenomenon in an infant: a case report and review of Literature. Pediatric Rheumatology 2011, 9:16 Fredrick M. Wigley M.D. Raynaud’s Phenomenon. N Engl J Med, Vol. 347, No. 13, September 26, 2002. George Spencer-Green, MD, MS.

Outcomes in Primary Raynaud Phenomenon-A Meta-analysis of the Frequency, Rates, and Predictors of Transition to Secondary Disease. Arch Intern Med. 1998;158:595-600.