Buerger's and Raynaud's Disease: Summary

by Joseph Alpert, MD

Raynaud's phenomenon refers to an abnormally marked and sudden vasoconstrictive response to cold temperature or emotional stress. The condition was first described by a medical student, Maurice Raynaud, in 1862. These "vasospastic attacks" are usually but not always limited to the fingers or toes and are associated with sharply demarcated triphasic color changes at the distal portions of the digits. There is initial blanching with numbness, followed by cyanosis, both of which correspond to the phase of constricted blood flow; subsequently, there is a red blush of reperfusion after rewarming or resolution of the provocative stressful event. Raynaud's phenomenon may be primary (idiopathic) or secondary. Patienten*innen stellen sich häufig im zweiten und dritten Lebensjahrzehnt mit einer rezidivierenden, intermittierenden Makrohämaturie vor. Viele Patienten*innen haben asymptomatische Verläufe und fallen in Routineuntersuchungen durch eine Mikrohämaturie und/oder Proteinurie auf. Häufig hatten die Betroffenen einen vorausgegangenen Infekt der oberen Atemwege oder des Magen-Darm-Trakts. Die Diagnose wird anhand von Anamnese, klinischem Erscheinungsbild und Labordiagnostik gestellt. Die sichere Diagnosestellung erfolgt durch eine Nierenbiopsie mit Immunfluoreszenzfärbung. Da die Erkrankung meist einen guten Verlauf hat, wird die Nierenbiospie nur bei schweren oder chronischen Verläufen durchgeführt. Die Behandlung ist abhängig vom Schweregrad der Proteinurie, der Nierenfunktion und den pathologischen Veränderungen. Zu den Behandlungsmöglichkeiten zählen ACE-Hemmer oder Angiotensin-Rezeptor-Blocker (ARBs), um das Fortschreiten der Krankheit zu verlangsamen. Eine persistierende Proteinurie und ein Anstieg des Kreatinins sind Indikationen für eine immunsuppressive Therapie mit Glukokortikoiden und ggf. Zytostatika.

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00:00 So in summary, then: • Buerger's disease is arterial obstruction of very small and medium-sized blood vessels, usually in the hands and feet. It can lead to gangrene, or death of tissue, at the tips of the fingers and the toes. And it's probably an autoimmune disease but… that's triggered by tobacco products.

00:23 • Raynaud's phenomenon, on the other hand: There's spontaneous spasm in the blood vessels.

00:29 This causes white discoloration of the fingers, which eventually, fingers turn blue from low levels of oxygen in the blood. And then eventually, when the hand warms, the skin returns to bright red. The classification is either primary Raynaud's—in other words, actually Raynaud's disease—or it's secondary either to an autoimmune disease or to the fact that the person is just very sensitive to cold. • And the treatment is, of course, no smoking, vasodilators, and avoidance or protection from cold.

About the Lecture

The lecture Buerger's and Raynaud's Disease: Summary by Joseph Alpert, MD is from the course Arterial Diseases.

Included Quiz Questions

Which of the following is most likely to exacerbate symptoms in patients with Buerger’s disease or Raynaud’s disease?

Cold temperatures
Increased moisture
Dry weather
Excess heat

Author of lecture Buerger's and Raynaud's Disease: Summary

Joseph Alpert, MD

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Everything explained thoroughly

By ghofran h. on 17. November 2020 for Buerger's and Raynaud's Disease: Summary

I love his lectures , he explains everything thoroughly , answers almost every question that I have in the video .

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