Raynaud’s syndrome and RA

Raynaud’s syndrome, also called Raynaud’s phenomenon, is a condition that involves brief episodes of vasospasm where blood vessels narrow, resulting in a decrease in blood flow mainly to toes and fingers, but sometimes to other extremities, including the nose, lips, ears, and nipples. An attack or episode of Raynaud’s can be brought on by stress or cold temperatures.

During an episode, blood flow is decreased or stopped, so your fingers or toes (or other extremities) may turn white and then blue. As blood flow returns, whatever area is affected will turn red and there may be a throbbing, tingling, or burning sensation. The cause of Raynaud’s syndrome is not known.

 

Association between Raynaud’s and RA

The prevalence of Raynaud’s syndrome in patients with RA has been estimated at about 12%, compared with 5% for the general population.1,2 The mechanism that accounts for the development of Raynaud’s in patients with RA is not clear. RA is thought to be associated with decreased vasodilation (the ability of blood vessels to dilate) and other changes in blood vessels and factors involved in coagulation.3 All of these have been shown to play a role in the development of Raynaud’s and may explain the greater risk for Raynaud’s in patients with RA. Additionally, Raynaud’s is common in patients with other rheumatic conditions, such as scleroderma and Sjögren’s syndrome, which can occur with RA.1


 

Factors that may increase risk for Raynaud’s syndrome

Raynaud’s syndrome is more common in women than men and it is thought that hormonal factors may play a role in increased risk for developing the condition. However, at present it is unclear what role hormones may play. There is conflicting evidence concerning the role that smoking may play in increasing risk for Raynaud’s syndrome. However, smoking is associated with changes in blood vessels and increased viscosity of blood that may contribute to the severity of Raynaud’s syndrome.3

 

What to expect if you have Raynaud’s syndrome

In most cases, Raynaud’s syndrome, when it occurs by itself, is not associated with long-term problems. In a minority of cases, the condition can be severe and lead to the development of sores and tissue damage, with risk of gangrene. There is evidence that Raynaud’s syndrome that develops in RA does not lead to increased disability. One small study found that RA patients with Raynaud’s syndrome affecting the hands (the most common area affected by the syndrome) did not experience significant decreases in function above and beyond disability associated with RA.4

If you experience the symptoms or signs of Raynaud’s syndrome, speak with your doctor and make sure you monitor your condition to ensure that serious complications do not develop.

 

Treatment options for Raynaud’s syndrome

Treatment for Raynaud’s syndrome, where the condition is severe enough to warrant treatment, may include a variety of agents that inhibit vasoconstriction (angiotensin-converting enzyme or ACE inhibitors and selective serotonin reuptake inhibitors or SSRIs) or increase vasodilation (transdermal nitrous oxide). If you have Raynaud’s syndrome and smoke, it is important to quit smoking because of the potential increase in severity of the condition. Antioxidant supplementation, including vitamins C, A, and E) may also be useful in improving the symptoms of Raynaud’s syndrome.

Written by: Jonathan Simmons | Last reviewed: September 2013.
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