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Fenômeno de Raynaud

Last reviewed: 20 Aug 2025
Last updated: 04 Oct 2024

Summary

定义

病史和体格检查

关键诊断因素

  • presença de fatores de risco
  • dor ou desconforto nos dedos
  • parestesia digital
  • palidez dos dedos
  • descoloração vermelha e/ou azul dos dedos
  • capilares dilatados no leito ungueal
  • descoloração bem definida
  • ampliação dos leitos ungueais
完整详情

其他诊断因素

  • pirose
  • disfagia
  • mãos inchadas
  • pele rígida
  • artralgia
  • fotossensibilidade
  • úlceras orais/nasais
  • alopécia
  • erupção cutânea em forma de borboleta
  • esclerodactilia
  • telangiectasia
  • dor torácica pleurítica
  • úlceras digitais
  • nódulos digitais
  • reabsorção dos tufos digitais
  • gangrena da ponta do dedo ou do dedo
  • lesões vermelhas dolorosas salientes nas pontas dos dedos
  • autoamputação
完整详情

危险因素

  • mulheres
  • história familiar
  • doença do tecido conjuntivo
  • uso de determinados medicamentos
  • lesão por vibração
  • Doença de Buerger
  • exposição prolongada ao frio/congelamento das extremidades
  • clima mais frio
  • tabagismo
  • isquemia
  • enxaqueca
  • glaucoma
完整详情

诊断性检查

首要检查

  • diagnóstico clínico
  • fator antinuclear (FAN)
  • Hemograma completo
  • velocidade de hemossedimentação
  • proteína C-reativa
  • urinálise
完整详情

需考虑的检查

  • capilaroscopia
完整详情

治疗流程

急症处理

fenômeno de Raynaud (FR) secundário grave: isquemia crítica, com úlceras digitais ou risco de perda de dedos

持续性治疗

fenômeno de Raynaud (FR) primário ou secundário leve

撰稿人

作者

Janet Pope, MD, MPH, FRCPC
Janet Pope

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

利益声明

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.

同行评议者

Elena Schiopu, MD

Professor of Medicine

Rheumatologist

Medical College of Georgia at Augusta University

Charlie Norwood Veterans Affairs Medical Center

Augusta

GA

利益声明

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

利益声明

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

利益声明

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.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

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. 摘要

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.全文  摘要

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.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Fenômeno de Raynaud images
  • 鉴别诊断

    • Resposta normal ao frio
    • Cianose/crioglobulinemia
    • Frieira (perniose)
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  • 指南

    • 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
    更多 指南
  • 患者教育信息

    Abandono do hábito de fumar

    Fenômeno de Raynaud

    更多 患者教育信息
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