Información de la revista
Vol. 2. Núm. S3.
Esclerosis sistémica
Páginas S10-S15 (Noviembre 2006)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 2. Núm. S3.
Esclerosis sistémica
Páginas S10-S15 (Noviembre 2006)
Esclerosis sistémica
Acceso a texto completo
Fenómeno de Raynaud
Raynaud’s phenomenon
Visitas
27470
Miguel Ángel Saavedra Salinasa,
Autor para correspondencia
miansaavsa@yahoo.com.mx

Correspondencia: Dr. M.A. Saavedra Salinas. Seris y Zaachila, s/n, 7.° piso. Col. La Raza. CP 02990 México DF. México.
, Sandra Miriam Carrillo Vázquezb
a Departamento de Reumatología. Unidad Médica de Alta Especialidad. Hospital de Especialidades Dr. Antonio Fraga Mouret. Centro Médico Nacional La Raza. Instituto Mexicano del Seguro Social. México DF. México
b Hospital Primero de Octubre. ISSSTE. México DF. México
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas

El fenómeno de Raynaud se caracteriza por ataques isquémicos seguidos de vasodilatación de las zonas distales del cuerpo. Es una condición clínica frecuente en la práctica médica diaria; puede ser primario o asociado a diversas enfermedades, como las enfermedades reumáticas autoinmunitarias. Esta clasificación tiene implicaciones clínicas y terapéuticas. La revisión clínica cuidadosa del paciente es la forma más fiable y reproducible para el diagnóstico; otros métodos usados, sin embargo, se encuentran en el área experimental. Diversos factores de riesgo han sido involucrados en el desarrollo del fenómeno de Raynaud; no obstante, su patogenia no se ha dilucidado completamente, aunque es cierto que se ha descrito recientemente avances en su comprensión. Estos mecanismos descritos han impactado directamente en el desarrollo de nuevas terapias para el control de la enfermedad.

Palabras clave:
Fenómeno de Raynaud
Patogenia
Tratamiento
Abstract

Raynaud’s phenomenon is characterized by repeated daily attacks of ischemia followed by reperfusion at the acrallevel. It is a frequent syndrome found in medical practice; and it can be considered as primary or secondary to other conditions, including rheumatic autoimmune diseases. Current classification had clinical and therapeutic implications. Careful clinical evaluation is the most reliable and reproducible method in the diagnosis of Raynaud’s phenomenon. Several risk factors had been associated in the genesis of Raynaud’s phenomenon; however, its pathogenesis remains elusive although recently, considerable progress in disease mechanism had been described. Such advances are directing new lines of therapy.

Key words:
Raynaud’s phenomenon
Pathogenesis
Therapy
El Texto completo está disponible en PDF
Bibliografía
[1.]
F.M. Wigley.
Clinical practice: Raynaud’s phenomenon.
N Engl J Med, 347 (2002), pp. 1001-1008
[2.]
J.C.R. Bowling, P.M. Dowd.
Raynaud’s disease.
Lancet, 361 (2003), pp. 2078-2080
[3.]
L. Fraenkel.
Raynaud’s phenomenon: epidemiology and risk factors.
Curr Rheumatol Rep, 4 (2002), pp. 123-128
[4.]
G. Riera, M. Vilardell, J. Vacque, V. Fonollosa, B. Bermejo.
Prevalence of Raymaud’s phenomenon in a healthy Spanish population.
J Rheumatol, 20 (1993), pp. 66-69
[5.]
H.R. Maricq, P.H. Carpentier, M.C. Weinrich, J.E. Keil, A. Franco, P. Drouet, et al.
Geographic variation in the prevalence of Raynaud’s phenomenon: Charleston, SC, USA vs Tarentaise, Savoie, France.
J Rheumatol, 20 (1993), pp. 70-76
[6.]
H.R. Maricq, P.H. Carpentier, M.C. Weinrich, J.E. Keil, Y. Palesch, C. Biro, et al.
Geographic variation in the prevalence of Raynaud’s phenomenon: a 5 region comparison.
J Rheumatol, 24 (1997), pp. 879-889
[7.]
N. Olsen, S.L. Nielsen.
Prevalence of primary Raynaud’s phenomenon in young females.
Scand J Clin Lab Invest, 37 (1978), pp. 761-764
[8.]
A. Silman, S. Holligan, P. Brennan.
Prevalence of symptoms of Raynaud’s phenomenon in general practice.
BMJ, 301 (1990), pp. 590-592
[9.]
L.G. Suter, J.M. Murabito, D.T. Felson, L. Fraenkel.
The incidence and natural history of Raynaud’s phenomenon in the community.
Arthritis Rheum, 52 (2005), pp. 1259-1263
[10.]
P. Brennan, A. Silman, C. Black, R. Bernstein, J. Coppock, P. Maddison, et al.
Validity and reliability of three methods used in the diagnosis of Raynaud’s phenomenon.
Br J Rheumatol, 32 (1993), pp. 357-361
[11.]
S.T. O’Keefe, T.P. Tsapatsaris, W.P. Beethman Jr.
Color chart assisted diagnosis of Raynaud’s phenomenon in an unselected hospital employee population.
J Rheumatol, 19 (1992), pp. 1415-1417
[12.]
J. Leppert, H. Aberg, I. Ringqvist, S. Sorensson.
Raynaud’s phenomenon in a female population: prevalence and association with other conditions.
Angiology, 38 (1987), pp. 871-877
[13.]
I. Valter, H.R. Maricq.
Prevalence of Raynaud’s phenomenon in 2 ethnic groups in the general population of Estonia.
J Rheumatol, 25 (1998), pp. 697-702
[14.]
L. Fraenkel, Y.Q. Zhang, C.E. Chaisson, H.R. Maricq, S.R. Evans, F. Brand, et al.
Different factors influence the expression of Raynaud’s phenomenon in men and women.
[15.]
N. Harada, A. Ueda, S. Takegata.
Prevalence of Raynaud’s phenomenon in japanese males and females.
J Clin Epidemiol, 44 (1991), pp. 649-655
[16.]
K.T. Palmer, M.J. Griffin, H. Syddall, B. Pannett, C. Cooper, D. Coggon.
Prevalence of Raynaud’s phenomenon in Great Britain and its relation to hand transmitted vibration: a national postal survey.
Occup Environ Med, 57 (2000), pp. 448-452
[17.]
M. Bovenzi.
Hand-arm vibration induced white finger among quarry drillers and stonecarvers.
Occup Environ Med, 51 (1994), pp. 603-611
[18.]
J.A. Block, W. Sequeira.
Raynaud’s phenomenon.
Lancet, 357 (2003), pp. 2042-2048
[19.]
R.R. Freedman, M.D. Mayes.
Familial aggregation of primary Raynaud’s disease.
Arthritis Rheum, 39 (1996), pp. 1189-1191
[20.]
E. Susol, A.J. MacGregor, J.H. Barret, H. Wilson, C. Black, K. Welsh, et al.
A two-stage genome Wide screen for susceptibility loci in primary Raynaud’s phenomenon.
[21.]
J. Heslop, D. Coggon, E.D. Acheson.
The prevalence of intermittent digital ischemia (Raynaud’s phenomenon) in a general practice.
J Roy Coll Gen Pract, 33 (1983), pp. 85-89
[22.]
L. Fraenkel, Y. Zhang, C. Chaisson, S.R. Evans, P.W. Wilson, D.T. Felson.
The association of estrogen replacement therapy and Raynaud’s phenomenon in postmenopausal women.
Ann Intern Med, 129 (1998), pp. 208-211
[23.]
Y.Y. Palesch, I. Valter, P.H. Carpentier, H.R. Maricq.
Association between cigarette and alcohol consumption and Raynaud’s phenomenon.
J Clin Epidemiol, 52 (1999), pp. 321-328
[24.]
J.E. Keil, H.R. Maricq, M.C. Weinrich, A.R. McGregor, F. Diat.
Demographic, social and clinical correlates of Raynaud phenomenon.
Int J Epidemiol, 20 (1991), pp. 221-224
[25.]
L. Fraenkel, G.H. Tofler, Y.Q. Zhang.
The associations between plasma levels of von Willebrand factor and fibrinogen with Raynaud’s phenomenon in men and women.
Am J Med, 108 (2000), pp. 583-586
[26.]
G. Spencer-Green.
Outcomes in primary Raynaud phenomenon: a metaanalysis of the frecuency, rates, and predictors of transition to secondary disease.
Arch Intern Med, 158 (1998), pp. 595-600
[27.]
E.C. Leroy, T.A. Medsger Jr.
Raynaud’s phenomenon: a proposal for classification.
Clin Exp Rheumatol, 10 (1992), pp. 485-488
[28.]
J. Sarkozi, A.A.M. Bookman, P. Lee, E.C. Keystone, M.J. Fritzler.
Significance of anticentromere antibody in idiopathic Raynaud’s syndrome.
Am J Med, 83 (1987), pp. 893-898
[29.]
P. Caramaschi, D. Biasi, T. Manzo, A. Carletto, F. Poli, L.M. Bambara.
Anticentromere antibody-clinical associations: a study of 44 patients.
Rheumatol Int, 14 (1995), pp. 253-255
[30.]
G.J. Landry, J.M. Edwards, R.B. McLafferty, L.M. Taylor Jr, J.M. Porter.
Long-term outcome of Raynaud’s syndrome in a prospectively analyzed patient cohort.
J Vasc Surg, 23 (1996), pp. 76-78
[31.]
M. Cutolo, W. Grassi, M. Matucci.
Raynaud phenomenon and the role of capillaroscopy.
Arthritis Rheum, 48 (2003), pp. 3023-3030
[32.]
M. Cutolo, C. Pizzorni, A. Sulli.
Capillaroscopy.
Best Pract Res Clin Rheumatol, 19 (2005), pp. 437-452
[33.]
E.J. Ter Borg, G. Piersma-Wichers, A.J. Smith, C.G.M. Kallenberg, A.A. Wouta.
Serial naifold capillary microscopy in primary Raynaud’s phenomenon and scleroderma.
Semin Arthritis Rheum, 24 (1994), pp. 40-47
[34.]
M. Meli, G. Gitzelmann, R. Koppensteiner, B.R. Amann-Vesti.
Predictive value of naifold capillaroscopy in patients with Raynaud’s phenomenon [publicación electrónica].
Clin Rheumatol, 25 (2006), pp. 153-158
[35.]
M. Cutolo, A. Sulli, C. Pizzorni, S. Accardo.
Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis.
J Rheumatol, 27 (2000), pp. 155-160
[36.]
M. Cutolo, C. Pizzorni, M. Tuccio, A. Burroni, C. Craviotto, M. Basso, et al.
Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis.
Rheumatology (Oxford), 43 (2004), pp. 719-726
[37.]
A.K. Murray, A.L. Eric, T.A. King.
Laser Doppler imaging: a developing technique for application in rheumatic diseases.
Rheumatology (Oxford), 43 (2004), pp. 1210-1218
[38.]
A. Sarikaya, T. Edge, M.F. Firat, E.l Duran.
Assessment of digital ischaemia and evaluation of response to therapy by 99mTc sestamibi limb scintigraphy after local cooling of the hands in patients with vasospastic Raynaud’s syndrome.
Nucl Med Commun, 25 (2004), pp. 207-211
[39.]
T. Lewis.
Experiments relating to the peripheral mechanism involced in spasmodic arrest of circulation in fingers, a variety of Raynaud’s disease.
Heart, 15 (1929), pp. 7-101
[40.]
A.L. Herrick.
Pathogenesis of Raynaud’s phenomenon.
Rheumatology (Oxford), 44 (2005), pp. 587-596
[41.]
F. Boin, F.M. Wigley.
Understanding, assessing and treating Raynaud’s phenomenon.
Curr Opin Rheumatol, 17 (2005), pp. 752-760
[42.]
M. Worda, R. Sgonc, H. Dietrich, H. Niederegger, R.S. Sundick, M.E. Gershwin, et al.
In vivo analysis of the apoptosis including effect of anti-endothelial cell antibodies in systemic sclerosis by the chorionallantoic membrana assay.
Arthritis Rheum, 48 (2003), pp. 2605-2614
[43.]
N.A. Flavahan, S. Flavahan, S. Mitra, M.A. Chotani.
The vasculopathy of Raynaud’s phenomenon and scleroderma.
Rheum Dis Clin North Am, 29 (2003), pp. 275-291
[44.]
P.B. Furspan, S. Chatter, R.R. Freedman.
Increased tyrosine phosphorylation mediates the cooling-induced contraction and increased vascular reactivity of Raynaud’s disease.
Arthritis Rheum, 50 (2004), pp. 1578-1585
[45.]
P.B. Furspan, S. Chatterjec, M.D. Mayes, R.R. Freedman.
Cooling-induced contraction and protein tyrosine kinase activity of isolated arterioles in secondary Raynaud’s phenomenon.
Rheumatology (Oxford), 44 (2005), pp. 488-494
[46.]
F.M. Wigley, N.A. Flavahan.
Raynaud’s phenomenon.
Rheum Dis Clin North Am, 22 (1996), pp. 765-781
[47.]
S. Generini, J.R. Seibold, M. Matucci-Cerinic.
Estrogens and neuropeptidesin Raynaud’s phenomenon.
Rheum Dis Clin North Am, 31 (2005), pp. 177-186
[48.]
S. Guimaraes, D. Moura.
Vascular adrenoreceptors: an update.
Pharmacol Rev, 53 (2001), pp. 319-356
[49.]
N.A. Flavahan, S. Flavahan, Q. Liu, S. Wu, W. Tidmore, C.M. Wiener, et al.
Increased α2-adrenergic constriction of isolated arterioles in diffuse scleroderma.
[50.]
L. Ekenvall, L.E. Lindblad.
Is vibration white finger a primary sympathetic nerve injury?.
Br J Ind Med, 43 (1986), pp. 702-706
[51.]
M.M. Cerinic, G. Valentinie, G.G. Sorano, S. d’Angelo, G. Cuomo, L. Fenu, et al.
Blood coagulation, fibrinolysis, and smarkers of endotelial dysfunction in systemic sclerosis.
Semin Arthritis Rheum, 32 (2003), pp. 285-295
[52.]
M. Bashar Kahalet.
Raynaud phenomenon and the vascular disease in scleroderma.
Curr Opin Rheumatol, 16 (2004), pp. 718-722
[53.]
A.L. Herrick.
Treatment of Raynaud’s phenomenon: new insights and developments.
Curr Rheumatol Rep, 5 (2003), pp. 168-174
[54.]
B.J. Harrison, A.J. Silman, S. Hider, A.L. Herrick.
Cigarette smoking: a risk factor for digital vascular complications in systemic sclerosis.
Arthritis Rheum, 46 (2002), pp. 3312-3316
[55.]
L.K. Hummers, F.M. Wigley.
Management of Raynaud’s phenomenon and digital ischemic lesions in scleroderma.
Rheum Dis Clin North Am, 29 (2003), pp. 293-313
[56.]
A. Reilly, B. Snyder.
Raynaud phenomenon.
AJN, 105 (2005), pp. 56-65
[57.]
Raynaud’s treatment study investigators.
Comparison of sustained-release nifedipine and temperature biofeedback for treatment of primary Raynaud’s phenomenon. Results from a randomized clinical with 1-year follow-up.
Arch Intern Med, 160 (2000), pp. 1101-1108
[58.]
A.E. Thompson, B. Shea, V. Welch, D. Fenlon, J. Pope.
Calcium-channel blockers for Raynaud’s phenomenon in systemic sclerosis.
[59.]
A. Thompson, J. Pope.
Calcium-channel blockers for primary Raynaud’s phenomenon: a meta-analysis.
Rheumatology (Oxford), 44 (2005), pp. 145-150
[60.]
S.D. Janini, D.J. Scott, J.S. Coppock.
Enalapril in Raynaud’s phenomenon.
J Clin Pharm Ther, 13 (1988), pp. 145-150
[61.]
V.F. Challenor, D.G. Waller, R.A. Hayward.
Subjective and objective assessment of enalapril in primary Raynaud’s phenomenon.
Br J Clin Pharmacol, 31 (1991), pp. 477-480
[62.]
M. Dziadzio, C.P. Denton, R. Smith.
Losartan therapy for Raynaud phenomenon and scleroderma: clinical and biochemical findings in a fifteenweek randomized parallel-group controlled trial.
[63.]
J.E. Pope, D. Fenlon, D. Furst.
Prazosin for Raynaud’s phenomenon in progressive systemic sclerosis.
Cochrane Database Syst Rev, 2 (2000),
[64.]
R. Wise, F. Wigley, B. White, B. White, G. Leatherman, J. Zhoong, et al.
Efficacy and tolerability of a selective α2C-adrenergic receptor blocker in recovery from cold induced vasospasm in scleroderma patients.
Arthritis Rheum, 50 (2004), pp. 3994-4001
[65.]
L.S. Teh, J. Maninng, T. Moore.
Sustained-release transdermal glyceryl trinitrate patches as a treatment for primary and secondary Raynaud’s phenomenon.
Br J Rheumatol, 34 (1995), pp. 636-641
[66.]
F. Khan, J.J.F. Belch.
Skin blood flow in patients with systemic sclerosis and Raynaud’s phenomenon: effects of oral L-arginine supplementation.
J Rheumatol, 26 (1999), pp. 2389-2394
[67.]
S.A. Cotton, A.L. Eric, M.I.V. Jayson, A.J. Freemant.
Endotelial expression ofnitric oxide synthases and nitrotyrosine in systemic sclerosis skin.
J Phatol, 189 (1999), pp. 273-278
[68.]
B. Marasini, M. Massarotti, B. Bottasso, R. Coppola, N.D. Papa, W. Maglione, et al.
Comparison between iloprost and alprostadil in the treatment of Raynaud’s phenomenon.
Scan J Rheumatol, 33 (2004), pp. 253-256
[69.]
M. Kirchengast, K. Munter.
Endothelin-1 and endothelin receptor antagonist in cardiovascular remodelling.
Proc Soc Exp Biol Med, 221 (1999), pp. 312-325
[70.]
J.H. Korn, M. Mayes, M. Matucci-Cerinic, M. Rainisio, J. Pope, E. Hachulla, et al.
Digital ulcers in systemic sclerosis: prevention by treatment with bosentan, an oral endothelin receptor antagonist.
Arthritis Rheum, 50 (2004), pp. 3985-3993
[71.]
C. Mehats, C.B. Andersen, M. Filopanti.
Cyclic nucleotide phosphodiesterases and their role in endocrine cell signaling.
Trends Endocrinol Metab, 13 (2002), pp. 29-35
[72.]
C.R. Kumana, G.T. Cheung, C.S. Lau.
Severe digital ischaemia treated with phosphodiesterase inhibitors.
Ann Rheum Dis, 63 (2004), pp. 1522-1524
[73.]
M. Baumhaekel, P. Scheffler, M. Boehm.
Use of tadalafil in a patient with a secondary Raynaud’s phenomenon no responding to sildenafil.
Microvasc Res, 69 (2005), pp. 178-179
[74.]
S. Rajagopalan, D. Pfenninger, E. Somers.
Effects of cilostazol in patients with Raynaud’s syndrome.
Am J Cardiol, 92 (2003), pp. 1310-1315
[75.]
C.P. Denton, T.D. Bunce, M.B. Dorado.
Probucol improves symptoms and reduces lipoprotein oxidation susceptibility in patients with Raynaud’sphenomenon.
Rheumatology (Oxford), 38 (1999), pp. 309-315
[76.]
A.L. Herrick, S. Hollis, D. Schofield.
A double-blind, placebo-controlled trial of antioxidant therapy in limited cutaneus systemic sclerosis.
Clin Exp Rheumatol, 18 (2000), pp. 349-356
[77.]
C.P. Denton, K. Howell, R.J. Sttraton, C.M. Black.
Long-term low molecular weight heparin therapy for severe Raynaud’s phenomenon: a pilot study.
Clin Exp Rheumatol, 18 (2000), pp. 499-502
[78.]
S. Lakshminarayanan, S.J. Maestrillo, D. Vazquez-Abad, J.R. Waterman.
Treatment of severe Raynaud’s phenomenon with ischemic ulcerations with tissue plasminogen activator.
Clin Expl Rheumatol, 17 (1999), pp. 260
[79.]
J. Pope, D. Fenlon, A. Thompson, et al.
Ketanserin for Raynaud’s phenomenon in progressive systemic sclerosis (Cochrane review).
The Cochrane Library, Update Software, (2002),
[80.]
B. Coleiro, S.E. Marshall, C.P. Denton.
Treatment of Raynaud’s phenomenon with the selective serotonin reuptake inhibidor fluoxetine.
Rheumatology (Oxford), 40 (2001), pp. 1038-1043
[81.]
T. Sycha, M. Graninger, E. Auff, P. Schnider.
Botulinum toxin in the treatmentof Raynaud’s phenomenon:a pilot study.
Eur J Clin Invest, 34 (2003), pp. 312-313
[82.]
D.M. Sibell, A.J. Colantonio, B.R. Stacey.
Successful use of spinal cord stimulation in the treatment of severe Raynaud’s disease of the hands.
Anesthesiology, 102 (2005), pp. 225-227
[83.]
M. Hirschal, R. Katzenschlager, C. Francesconi, M. Kundi.
Low level lasser therapy in primary Raynaud’s phenomenon: results of a placebocontrolled, double-blind intervention study.
J Rheumatol, 31 (2004), pp. 2408-2412
[84.]
T.E. McCall, D.P. Petersen, L.B. Wong.
The use of digital artery sympathectomy as a salvage procedure for severe ischemia of Raynaud’s disease and phenomenon.
J Hand Surg, 24 (1999), pp. 173-177
[85.]
M.M. Tomaino, R.J. Goitz, T.A. Medger.
Surgery for ischemic pain and Raynaud’s phenomenon in scleroderma: a description of treatment protocol and evaluation of results.
Microsurgery, 21 (2001), pp. 75-79
Copyright © 2006. Elsevier España S.L. Barcelona
Idiomas
Reumatología Clínica
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?