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afya Raynaud'sPhenomena

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20160425222505 Ben  
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primary or secondary

''Raynaud's disease'' (primary)
young women (30y) with symmetrical attacks
Factors suggesting underlying connective tissue disease
    onset after 40 years
    unilateral symptoms
    rashes
    presence of autoantibodies
    features which may suggest rheumatoid arthritis or SLE, for example arthritis or recurrent miscarriages
    digital ulcers, calcinosis
    very rarely: chilblains

''Secondary causes''
    connective tissue disorders: scleroderma (most common), rheumatoid arthritis, SLE
    leukaemia
    type I cryoglobulinaemia, cold agglutinins
    use of vibrating tools
    drugs: oral contraceptive pill, ergot
    cervical rib

''Management''
    first-line: calcium channel blockers e.g. nifedipine
    IV prostacyclin infusions: effects may last several weeks/months