Pathophysiology of Raynaud's disease

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Abstract
Rheumatoid arthritis, obstructive arterial disease, malignant neoplasm, blood dyscrasias and ergot toxicity are considered in the differential diagnosis of Raynaud''s disease characterized by vasospastic ischemia in patients. Normal physiology and pathophysiologic aspects of sympathetic regulation of blood flow are described during emotional stress and increased sensitivity to cold. Diagnosis is suggested by plethysmography, chest roentgenogram, hemogram, urine analysis, antinuclear antibody test, rheumatoid factor and serum protein electrophoresis to rule out differential considerations. Preventative therapy including tobacco smoking abstinence and cold exposure avoidance are described prior to specific drug therapy or radical sympathectomy. Autonomic agents such as oral reserpine, methyldopamine, phenoxybenzamine and tolazoline are proposed to increase digital blood flow.