Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presencia de factores de riesgo
- dolor/malestar digital
- parestesia digital
- palidez de los dedos
- decoloración roja y/o azul de los dedos
- capilares del lecho ungueal dilatados
- decoloración bien definida
- aumento del lecho ungueal
Outros fatores diagnósticos
- acidez
- disfagia
- hinchazón de manos
- piel tirante
- artralgia
- fotosensibilidad
- úlceras orales/nasales
- alopecia
- eritema en verspertilio
- esclerodactilia
- telangiectasia
- dolor torácico pleurítico
- úlceras digitales
- fosas digitales
- reabsorción de los penachos distales de las falanges
- gangrena en la punta de los dedos/el dedo entero
- lesiones rojas dolorosas y elevadas en las puntas de los dedos de la mano
- autoamputación
Fatores de risco
- sexo femenino
- antecedentes familiares
- enfermedad del tejido conjuntivo
- uso de determinados fármacos
- lesión por vibración
- enfermedad de Buerger
- exposición prolongada al frío/congelación
- clima más frío
- tabaquismo
- isquemia
- migraña
- glaucoma
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- diagnóstico clínico
- anticuerpo antinuclear
- hemograma completo (HC)
- velocidad de sedimentación globular
- proteína C-reactiva
- análisis de orina
Investigações a serem consideradas
- capilaroscopia
Algoritmo de tratamento
Fenómeno de Raynaud (FR) grave secundario: isquemia crítica con úlceras digitales o amenaza de pérdida digital
Fenómeno de Raynaud (FR) primario o secundario leve
Colaboradores
Autores
Janet Pope, MD, MPH, FRCPC
Professor of Medicine
Division of Rheumatology
Department of Medicine
University of Western Ontario
Schulich School of Medicine and Dentistry
Head
Division of Rheumatology
St. Joseph's Health Care
London
Ontario
Canada
Declarações
JP has been reimbursed for consulting with several pharmaceutical manufacturers unrelated to Rayaud’s phenomenon. JP’s institution receives research grants from BMS, Janssen, and Seattle Genetics. She has acted as a consultant for AbbVie, Amgen, AstraZeneca, BI, BMS, Celltrion, EMERALD, Frensenius Kabi, GSK, Janssen, JMP, Lilly, Mallinckrodt Pharmaceuticals, Mitsubishi Tanabe Pharma, Novartis, Organon, Pfizer, Sandoz, Samsung, and Viatris. JP is a speaker and advisory board member for AbbVie, Amgen, AstraZeneca, BI, BMS, Frensenius Kabi, GSK, Janssen, JMP, Lilly, Novartis, Organon, Pfizer, Sandoz, UCB, and Viatris. She receives no patents or royalties. JP is an author of a number of references cited in this topic.
Revisores
Elena Schiopu, MD
Professor of Medicine
Rheumatologist
Medical College of Georgia at Augusta University
Charlie Norwood Veterans Affairs Medical Center
Augusta
GA
Declarações
ES declares that she has no competing interests.
Ariane L. Herrick, MD FRCP
Reader in Rheumatology and Consultant Rheumatologist
Musculoskeletal Research Group
University of Manchester
Manchester
UK
Declarações
ALH has been a paid speaker for Actelion; a consultant for Actelion and Pfizer; and an investigator in studies sponsored by Actelion, Mediquest, and United Therapeutics. ALH is an author of a number of references cited in this topic.
Bridget Griffiths, MB ChB, MD, MRCP(UK)
Consultant Rheumatologist
Department of Rheumatology
Freeman Hospital
Newcastle upon Tyne
UK
Declarações
BG declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Curtiss P, Svigos K, Schwager Z, et al. Part I: epidemiology, pathophysiology, and clinical considerations of primary and secondary Raynaud's phenomenon. J Am Acad Dermatol. 2024 Feb;90(2):223-34. Resumo
Belch J, Carlizza A, Carpentier PH, et al. ESVM guidelines - the diagnosis and management of Raynaud's phenomenon. Vasa. 2017 Oct;46(6):413-23.Texto completo Resumo
Kowal-Bielecka O, Fransen J, Avouac J, et al. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2017 Aug;76(8):1327-39.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Respuesta normal al frío
- Cianosis/crioglobulinemia
- Sabañones (perniosis)
Mais Diagnósticos diferenciaisDiretrizes
- The 2024 British Society for Rheumatology guideline for management of systemic sclerosis
- EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis
Mais DiretrizesFolhetos informativos para os pacientes
Abandono del hábito de fumar
Fenómeno de Raynaud
Mais Folhetos informativos para os pacientes
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