Fenómeno de Raynaud
Palabras clave:
fenómeno de Raynaud, vasoespasmo, arterias digitales, endotelio, antagonista de calcio, esclerosis sistémicaResumen
El fenómeno de Raynaud se define como una alteración caracterizada por un vasoespasmo episódico de las arterias y arteriolas periféricas, seguido de vasodilatación y reperfusión, que resulta en palidez, cianosis y eritema. Se clasifica como primario, cuando no se asocia con otras enfermedades, o secundario, cuando se presenta como parte de otra entidad, entre las que se incluyen las enfermedades autoinmunitarias, la exposición a ciertos fármacos como la ergotamina o agentes químicos como bleomicina, la exposición a la vibración, los estados de hiperviscosidad e, incluso, la obstrucción vascular extrínseca.
La presentación clínica puede variar desde un cuadro leve, casi imperceptible, hasta casos graves con isquemia digital que da origen a úlceras y puede llegar incluso a gangrena con pérdida del dedo. El tratamiento va dirigido a favorecer la vasodilatación, inhibir la vasoconstricción, reducir el daño endotelial e inhibir la agregación de plaquetas. En el tratamiento farmacológico se incluyen antagonistas del calcio, vasodilatadores, prostaglandinas, inhibidores de la fosfodiesterasa, simpaticolíticos, inhibidores de las cinasas, anticoagulantes, antitrombóticos y antioxidantes, entre otros.
Biografía del autor/a
Karen Zapata
Médica, residente de Dermatología, Universidad del Valle, Cali, Colombia
Lucy García
Médica dermatóloga, especialista en Docencia Universitaria, M. Sc. en Ciencias Básicas Médicas con énfasis en Inmunología, Universidad del Valle, Cali, Colombia
Referencias bibliográficas
1. Bakst R, Merola J, Franks A, Sánchez M. Raynaud’s phenomenon: Pathogenesis and management. J Am Acad Dermatol. 2008;59:633-53.
2. Raynaud M. Local Asphyxia and Symmetrical Gangrene of the Extremities.London: New Sydenham Society. 1862.
3. Landry GJ, Edwards JM, McLafferty RB, Taylor LM Jr, Porter JM. Long-term outcome of Raynaud’s syndrome in a prospectively analyzed patient cohort. J Vasc Surg. 1996;23:76-8.
4. Spencer-Green G. Outcomes in primary Raynaud phenomenon: a metaanalysis of the frequency, rates and predictors of transition to secondary disease. Arch Intern Med. 1998;158:595-600.
5. Maricq HR, Carpentier PH, Weinrich MC, Keil JE, Palesch Y, Biro C, et al. Geographic variation in the prevalence of Raynaud’s phenomenon: a 5 region comparison. J Rheumatol. 1997;24:879-89.
6. Block JA, Sequeira W. Raynaud’s phenomenon. Lancet. 2001; 357:2042- 8
7. LeRoy EC, Medsger TA Jr. Raynaud’s phenomenon: a proposal for classification. Clin Exp Rheumatol. 1992;10:485–8.
8. Hummers LK, Wigley FM. Management of Raynaud’s phenomenon and digital ischemic lesions in scleroderma. Rheum Dis Clin North Am 2003;29:293-313.
9. Boin F, Wigley FM. Understanding, assessing and treating Raynaud’s phenomenon. Curr Opin Rheumatol. 2005;17:752-60.
10. Lewis T. Experiments relating to the peripheral mechanism involved in spasmodic arrest of the circulation of the fingers: a variety of Raynaud’s disease.Heart. 1929;14:7-101.
11. Herrick AL. Pathogenesis of Raynaud's phenomenon. Rheumatol 2005;44:587–96.
12. Fukata Y, Amano M, Kaibuchi K. Rho-Rho-kinase pathway in smooth muscle contrac tion and cytoskeletal reorganization of non-muscle cells. Trends Pharmacol Sci 2001; 22:32–9.
13. Takagi K, Kawaguchi Y, Hara M, Sugiura T, Harigai M, Kamatani N. Serum nitric oxide (NO) levels in systemic sclerosis patients: correlation between NO levels and clinical features. Clin Exp Immunol 2003;134:538-44.
14. Guiducci S, Giacomelli R, Matucci Cerinic M. Vascular complications of scleroderma. Autoimmun Rev. 2007;6:520-3.
15. Szabo N, Csiki Z, Szanto A, Danko K, Szodoray P, Zeher M. Functional and morphological evaluation of hand microcirculation with nailfold capillaroscopy and laser Doppler imaging in Raynaud´s and Sjögren´s syndrome and poly/dermatomyositis. Scand J Rheumatol. 2008;37:23-9.
16. Yucel B, Kubat A, Ozbey N, Kamali S, Yager J. Anorexia nervosa and Raynaud phenomenon: A case report. Int J Eat Disord. 2007;40:762-5.
17. Constantinescu C. Migraine and Raynaud’s phenomenon: Possible late complications of Kawasaki disease. Headache. 2002;42:227-9.
18. Suter L, Murabito J, Felson D, Fraenkel L. Smoking, alcohol consumption, and Raynaud´s phenomenon in middle age. Am J Med. 2007;120:264-71.
19. BotzoriV s, Drosos A A. Prise en charge du phénomène de Raynaud et des ulcères digitaux dans la sclérodermie systémique Revue du Rhumatisme 2011; 78: 307 -12
20. Wigley FM. Raynaud’s phenomenon. N Engl J Med 2002; 347:1001 - 8.
21. Kallemberg CG. Early detection of connective tissue disease in patients with Raynaud´s phenomenon. Rheum Dis Clin North Am. 1990;16:11-30.
22. Grader-Beck T, Wigley F M. Raynaud’s Phenomenon in Mixed Connective Tissue Disease Rheum Dis Clin N Am 2005;31:465–81
23. Zufferey P, Deparion M, Chamot A, Monti M. Prognostic significance in nailfold capillary microscopy in patients with Raynaud´s phenomenon and scleroderma-pattern abnormalities. A six year follow-up study. Clin Rheumatol. 1992;11:536-41.
24. Maricq H. Widefield capillary microscopy. Technique and rating scale for abnormalities seen in scleroderma and related disorders. Arthritis Rheum. 1981;24:1159-65.
25. Clark S, Dunn G, Moore T, Jayson M I; King TA, Herrick A. Comparison of thermography and laser Doppler imaging in the assessment of Raynaud’s phenomenon. Microvascular Res 2003; 66:73–6.
26. Csiki Z, Gal I, Szucs G, Andras C, Szegedi G. Comments on Raynaud’s syndrome based on laser Doppler studies. Orv Hetil. 1988;140:2285-8.
27. Bertuglia S, Leger P, Colantuoni A, Coppini G, Bendayan P, Boccalon H. Different flow motion patterns in healthy controls and patients with Raynaud’s phenomenon. Technol Health Care. 1999;7:1113-23.
28. Jeng J, Bridgeman A, Shivnan L, Thornton P, Alam H, Clarke T, et al. Laser Doppler imaging determines need for excision and grafting in advance of clinical judgement: a prospective blinded trial. Burns. 2003;29:665-70.
29. Roman Ivorra J. Treatment of Raynaud´s phenomenom. Med Clin (Barc) 2004; 122:499-500.
30. Johnson JP, Obasi C, Hahn MS, Glatleider P. Endoscopic thoracic sympathectomy. J Neurosurg Spine. 1999;91:90-7.
31. García-Carrasco M. El tratamiento del fenómeno de Raynaud. Rev Esp Reumatol 2000;27:322–7.
32. Lazareth I. Management of Raynaud´s phenomenon in French. Ann Dermatol Venereol. 2001;128:553-6.
33. Lekakis J, Mavrikakis M, Papamichael C, papazoglou S, Economou O, Scotiniotis I; et al. Short-term estrogen administration improves abnormal endothelial function in women with systemic sclerosis and Raynaud’s phenomenon. Am Heart J 1998; 136: 905–12.
34. Gayraud M. Raynaud’s phenomenon. Joint Bone Spine. 2007;74:1-8
35. Gliddon AE, Doré CJ, Black CM, McHugh N, Moots R, Denton Cp, et al. Prevention of vascular damage in scleroderma and autoimmune Raynaud’s phenomenon: a multicenter, randomized, double-blind, placebo-controlled trial of the angiotensin-converting enzyme inhibitor quinapril. Arthritis Rheum 2007;56:3837–46.
36. Hummers L, Wigley F. Management of Raynaud´s phenomenon and digital ischemic lesions in scleroderma. Rheum Dis Clin North Am. 2003;29:293-313.
37. Stosic-Grujicic S, Maksimovic D, Badovinac V, Samardzic T, Trajkovic V, Lukic M, et al. Antidiabetogenic effect of pentoxifylline is associated with systemic and target tissue modulation of cytokines and nitric oxide production. J Autoimmun. 2001;16:47-58.
38. Thompson AE, Shea B, Welch V, Fenlon D, Pope JE. Calcium channel blockers for Raynaud's phenomenon in systemic sclerosis. Arthritis Rheum. 2001;44:1841-7.
39. Thompson AE, Pope J. Calcium channel blockers for primary Raynaud's phenomenon: A meta-analysis. Rheumatology. 2005;44:145-50.
40. Abernethy DR, Schwartz JB. Calcium-antagonist drugs. N Engl J Med. 1999;341:1447-57.
41. Franks Jr AG. Topical glyceryl trinitrate as adjunctive treatment in Raynaud’s disease. Lancet 1982;1:76–7.
42. Teh LS, Manning J, Moore T, Tully MP, O´Reilly DO, Jayson MIV Sustained-release transdermal glyceryl trinitrate patches as a treatment for primary and secondary Raynaud’s phe- nomenon. Br J Rheumatol 1995;34:636–41.
43. Wise RA, Wigley FM, White B, Leatherman G, Zhong J, Krasa H, et al. Efficacy and tolerability of a selec tive alpha(2C)-adrenergic receptor blocker in recovery from coldinduced vasospasm in scleroderma patients: a single-center, double-blind, placebo- controlled, randomized crossover study. Arthritis Rheum 2004;50:3994–4001.
44. Wilkins MR, Paul GA, Strange JW, Tunariu N, Gin-Sing W, Banya WA, et al. Sildenafil versus endothelin receptor antagonist for pulmonary hypertension (SERAPH) study. Am J Respir Crit Care Med. 2005;171:1292-7.
45. Lichtenstein JR. Use of sildenafil citrate in Raynaud’s phenomenon: Comment on the article by Thompson, et al. Arthritis Rheum. 2003;28:282-3.
46. Kumana CR, Cheung GT, Lau CS. Severe digital ischemia treated with phosphodiesterase inhibitors. Ann Rheum Dis. 2004;63:1522-4
47. Fries R, Shariat K, von Wilmowsky H, Bohm M. Sildenafil in the treatment of Raynaud’s phenomenon resistant to vasodilatory therapy. Circulation. 2005;112:2980-5.
48. Stratton R, Shiwen X, Martini G, Holmes A, Leask A, Haberberger T, et al. Iloprost suppresses connective tissue growth factor production in fibroblasts and in the skin of scleroderma patients. J Clin Invest. 2001;108:241-50.
49. Zulian F, Corona F, Gerloni V, Falcini F, Buoncompagni A, Scarazatti M, et al. Safety and efficacy of iloprost for the treatment of ischaemic digits in pediatric connective tissue diseases. Rheumatology. 2004;43:229-33.
50. Scorza R, Caronni M, Mascagni B, Berruti V, Bazzi S, Micallef E, et al. Effects of long-term cyclic iloprost therapy in systemic sclerosis with Raynaud’s phenomenon: A randomized, controlled study. Clin Exp Rheumatol. 2001;19:503-8.
51. Opitz CF, Wensel R, Winkler J, Halank M, Bruch L, Kleber FX, et al. Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension. Eur Heart J. 2005;18:1895-902.
52. Rikitake Y, Liao JK. ROCKs as therapeutic targets in cardiovascular diseases. Expert Rev Cardiovasc Ther. 2005;3:441-51.
53. Fukumoto Y, Matoba T, Ito A, Tanaka H, Kishi T, Hayashidani S, et al. Acute vasodilator effects of a Rho-kinase inhibitor, fasudil, in patients with severe pulmonary hypertension. Heart. 2005;91:391-2.
54. Ishikura K, Yamada N, Ito M, Ota S, Nakamura M, Isaka N, et al. Beneficial acute effects of rho-kinase inhibitor in patients with pulmonary arterial hypertension. Circ J. 2006;70:174-8.
55. Sambo P, Amico D, Giacomelli R, Matucci-Cerinic M, SalsanoF, Valentini G, et al. Intravenous N-acetylcysteine for treatment of Raynaud’s phenomenon secondary to systemic sclerosis: A pilot study. J Rheumatol. 2001;28:2257-62
56. Herrick AL, Hollis S, Schofield D, Rieley F, Blann A, Griffin K, et al. A double-blind placebo-controlled trial of antioxidant therapy in limited cutaneous systemic sclerosis. Clin Exp Rheumatol. 2000;18:349-56.
57. Cookea JP, Marshall JM. Mechanisms of Raynaud's disease. Vasc Med. 2005;10:293-307.
58. Rey J, Cretel E, Jean R, Pastor MJ, Durand JM. Serotonin reuptake inhibitors, Raynaud’s phenomenon and erythromelalgia. Rheumatology. 2003;42:601-2.
59. García-Porrua C, Margarinos CC, González-Gay MA. Raynaud’s phenomenon and serotonin reuptake inhibitors. J Rheumatol. 2004;31:2090.
60. Coleiro B, Marshall SE, Denton CP, Howell K, Blann A, Welsh KI, et al. Treatment of Raynaud’s phenomenon with the selective serotonin reuptake inhibitor fluoxetine. Rheumatology. 2001;40:1038-43
61. Rubin LJ, Badesch DB, Barst RJ, Galie N, Black CM, Keogh A, et al. Bosentan therapy for pulmonary arterial hypertension. N Engl J Med. 2003;346:896-903
62. Denton CP, Humbert M, Rubin L, Black CM. Bosentan therapy for pulmonary arterial hypertension related to connective tissue disease: A subgroup analysis of the pivotal clinical trials and their open-label extensions. Ann Rheum Dis. 2006;65:1336-40.
63. Korn JH, Mayes M, Matucci Cerinic M, Rainisio M, Pope J, Hachulla E, et al. Digital ulcers in systemic sclerosis: Prevention by treatment with bosentan, an oral endothelin receptor antagonist. Arthritis Rheum. 2004;50:3985-93.
64. García de la Peña-Lefebvre P, Rodríguez S, Valero M, Carmona L, Gámir ML, Beltrán J, et al. Long-term experience of bosentan for treating ulcers and healed ulcers in systemic sclerosis patients. Rheumatology. 2008;47:464-6.
65. Morris JL, Jobling P, Gibbins IL. Differential inhibition by botulinum neurotoxin A of cotransmitters released from autonomic vasodilator neurons. Am J Physiol Heart Circ Physiol. 2001;281:H2124-32.
66. Alero F, Ditmars D, Siddiqui A. Botulinum toxin type A: A treatment option for digital ischemia in patients with Raynaud´s phenomenon. J Hist Sex. 2009;34:446-52.
67. Tomaino MM, Goitz RJ, Medsger TA. Surgery for ischemic pain and Raynaud's phenomenon in scleroderma: A description of treatment protocol and evaluation of results. Microsurgery. 2001;21:75-9.
68. Sibell DM, Colantonio AL, Stacey BR. Successful use of spinal cord stimulation in the treatment of severe Raynaud's disease of the hand. Anesthesiology. 2005;102:225-7
69. Park JH, Sung YK, Bae SC, Song SY, Seo HS, Jun JB Ulnar artery vasculopathy in systemic sclerosis Rheumatol Int 2009; 29:1081–6
2. Raynaud M. Local Asphyxia and Symmetrical Gangrene of the Extremities.London: New Sydenham Society. 1862.
3. Landry GJ, Edwards JM, McLafferty RB, Taylor LM Jr, Porter JM. Long-term outcome of Raynaud’s syndrome in a prospectively analyzed patient cohort. J Vasc Surg. 1996;23:76-8.
4. Spencer-Green G. Outcomes in primary Raynaud phenomenon: a metaanalysis of the frequency, rates and predictors of transition to secondary disease. Arch Intern Med. 1998;158:595-600.
5. Maricq HR, Carpentier PH, Weinrich MC, Keil JE, Palesch Y, Biro C, et al. Geographic variation in the prevalence of Raynaud’s phenomenon: a 5 region comparison. J Rheumatol. 1997;24:879-89.
6. Block JA, Sequeira W. Raynaud’s phenomenon. Lancet. 2001; 357:2042- 8
7. LeRoy EC, Medsger TA Jr. Raynaud’s phenomenon: a proposal for classification. Clin Exp Rheumatol. 1992;10:485–8.
8. Hummers LK, Wigley FM. Management of Raynaud’s phenomenon and digital ischemic lesions in scleroderma. Rheum Dis Clin North Am 2003;29:293-313.
9. Boin F, Wigley FM. Understanding, assessing and treating Raynaud’s phenomenon. Curr Opin Rheumatol. 2005;17:752-60.
10. Lewis T. Experiments relating to the peripheral mechanism involved in spasmodic arrest of the circulation of the fingers: a variety of Raynaud’s disease.Heart. 1929;14:7-101.
11. Herrick AL. Pathogenesis of Raynaud's phenomenon. Rheumatol 2005;44:587–96.
12. Fukata Y, Amano M, Kaibuchi K. Rho-Rho-kinase pathway in smooth muscle contrac tion and cytoskeletal reorganization of non-muscle cells. Trends Pharmacol Sci 2001; 22:32–9.
13. Takagi K, Kawaguchi Y, Hara M, Sugiura T, Harigai M, Kamatani N. Serum nitric oxide (NO) levels in systemic sclerosis patients: correlation between NO levels and clinical features. Clin Exp Immunol 2003;134:538-44.
14. Guiducci S, Giacomelli R, Matucci Cerinic M. Vascular complications of scleroderma. Autoimmun Rev. 2007;6:520-3.
15. Szabo N, Csiki Z, Szanto A, Danko K, Szodoray P, Zeher M. Functional and morphological evaluation of hand microcirculation with nailfold capillaroscopy and laser Doppler imaging in Raynaud´s and Sjögren´s syndrome and poly/dermatomyositis. Scand J Rheumatol. 2008;37:23-9.
16. Yucel B, Kubat A, Ozbey N, Kamali S, Yager J. Anorexia nervosa and Raynaud phenomenon: A case report. Int J Eat Disord. 2007;40:762-5.
17. Constantinescu C. Migraine and Raynaud’s phenomenon: Possible late complications of Kawasaki disease. Headache. 2002;42:227-9.
18. Suter L, Murabito J, Felson D, Fraenkel L. Smoking, alcohol consumption, and Raynaud´s phenomenon in middle age. Am J Med. 2007;120:264-71.
19. BotzoriV s, Drosos A A. Prise en charge du phénomène de Raynaud et des ulcères digitaux dans la sclérodermie systémique Revue du Rhumatisme 2011; 78: 307 -12
20. Wigley FM. Raynaud’s phenomenon. N Engl J Med 2002; 347:1001 - 8.
21. Kallemberg CG. Early detection of connective tissue disease in patients with Raynaud´s phenomenon. Rheum Dis Clin North Am. 1990;16:11-30.
22. Grader-Beck T, Wigley F M. Raynaud’s Phenomenon in Mixed Connective Tissue Disease Rheum Dis Clin N Am 2005;31:465–81
23. Zufferey P, Deparion M, Chamot A, Monti M. Prognostic significance in nailfold capillary microscopy in patients with Raynaud´s phenomenon and scleroderma-pattern abnormalities. A six year follow-up study. Clin Rheumatol. 1992;11:536-41.
24. Maricq H. Widefield capillary microscopy. Technique and rating scale for abnormalities seen in scleroderma and related disorders. Arthritis Rheum. 1981;24:1159-65.
25. Clark S, Dunn G, Moore T, Jayson M I; King TA, Herrick A. Comparison of thermography and laser Doppler imaging in the assessment of Raynaud’s phenomenon. Microvascular Res 2003; 66:73–6.
26. Csiki Z, Gal I, Szucs G, Andras C, Szegedi G. Comments on Raynaud’s syndrome based on laser Doppler studies. Orv Hetil. 1988;140:2285-8.
27. Bertuglia S, Leger P, Colantuoni A, Coppini G, Bendayan P, Boccalon H. Different flow motion patterns in healthy controls and patients with Raynaud’s phenomenon. Technol Health Care. 1999;7:1113-23.
28. Jeng J, Bridgeman A, Shivnan L, Thornton P, Alam H, Clarke T, et al. Laser Doppler imaging determines need for excision and grafting in advance of clinical judgement: a prospective blinded trial. Burns. 2003;29:665-70.
29. Roman Ivorra J. Treatment of Raynaud´s phenomenom. Med Clin (Barc) 2004; 122:499-500.
30. Johnson JP, Obasi C, Hahn MS, Glatleider P. Endoscopic thoracic sympathectomy. J Neurosurg Spine. 1999;91:90-7.
31. García-Carrasco M. El tratamiento del fenómeno de Raynaud. Rev Esp Reumatol 2000;27:322–7.
32. Lazareth I. Management of Raynaud´s phenomenon in French. Ann Dermatol Venereol. 2001;128:553-6.
33. Lekakis J, Mavrikakis M, Papamichael C, papazoglou S, Economou O, Scotiniotis I; et al. Short-term estrogen administration improves abnormal endothelial function in women with systemic sclerosis and Raynaud’s phenomenon. Am Heart J 1998; 136: 905–12.
34. Gayraud M. Raynaud’s phenomenon. Joint Bone Spine. 2007;74:1-8
35. Gliddon AE, Doré CJ, Black CM, McHugh N, Moots R, Denton Cp, et al. Prevention of vascular damage in scleroderma and autoimmune Raynaud’s phenomenon: a multicenter, randomized, double-blind, placebo-controlled trial of the angiotensin-converting enzyme inhibitor quinapril. Arthritis Rheum 2007;56:3837–46.
36. Hummers L, Wigley F. Management of Raynaud´s phenomenon and digital ischemic lesions in scleroderma. Rheum Dis Clin North Am. 2003;29:293-313.
37. Stosic-Grujicic S, Maksimovic D, Badovinac V, Samardzic T, Trajkovic V, Lukic M, et al. Antidiabetogenic effect of pentoxifylline is associated with systemic and target tissue modulation of cytokines and nitric oxide production. J Autoimmun. 2001;16:47-58.
38. Thompson AE, Shea B, Welch V, Fenlon D, Pope JE. Calcium channel blockers for Raynaud's phenomenon in systemic sclerosis. Arthritis Rheum. 2001;44:1841-7.
39. Thompson AE, Pope J. Calcium channel blockers for primary Raynaud's phenomenon: A meta-analysis. Rheumatology. 2005;44:145-50.
40. Abernethy DR, Schwartz JB. Calcium-antagonist drugs. N Engl J Med. 1999;341:1447-57.
41. Franks Jr AG. Topical glyceryl trinitrate as adjunctive treatment in Raynaud’s disease. Lancet 1982;1:76–7.
42. Teh LS, Manning J, Moore T, Tully MP, O´Reilly DO, Jayson MIV Sustained-release transdermal glyceryl trinitrate patches as a treatment for primary and secondary Raynaud’s phe- nomenon. Br J Rheumatol 1995;34:636–41.
43. Wise RA, Wigley FM, White B, Leatherman G, Zhong J, Krasa H, et al. Efficacy and tolerability of a selec tive alpha(2C)-adrenergic receptor blocker in recovery from coldinduced vasospasm in scleroderma patients: a single-center, double-blind, placebo- controlled, randomized crossover study. Arthritis Rheum 2004;50:3994–4001.
44. Wilkins MR, Paul GA, Strange JW, Tunariu N, Gin-Sing W, Banya WA, et al. Sildenafil versus endothelin receptor antagonist for pulmonary hypertension (SERAPH) study. Am J Respir Crit Care Med. 2005;171:1292-7.
45. Lichtenstein JR. Use of sildenafil citrate in Raynaud’s phenomenon: Comment on the article by Thompson, et al. Arthritis Rheum. 2003;28:282-3.
46. Kumana CR, Cheung GT, Lau CS. Severe digital ischemia treated with phosphodiesterase inhibitors. Ann Rheum Dis. 2004;63:1522-4
47. Fries R, Shariat K, von Wilmowsky H, Bohm M. Sildenafil in the treatment of Raynaud’s phenomenon resistant to vasodilatory therapy. Circulation. 2005;112:2980-5.
48. Stratton R, Shiwen X, Martini G, Holmes A, Leask A, Haberberger T, et al. Iloprost suppresses connective tissue growth factor production in fibroblasts and in the skin of scleroderma patients. J Clin Invest. 2001;108:241-50.
49. Zulian F, Corona F, Gerloni V, Falcini F, Buoncompagni A, Scarazatti M, et al. Safety and efficacy of iloprost for the treatment of ischaemic digits in pediatric connective tissue diseases. Rheumatology. 2004;43:229-33.
50. Scorza R, Caronni M, Mascagni B, Berruti V, Bazzi S, Micallef E, et al. Effects of long-term cyclic iloprost therapy in systemic sclerosis with Raynaud’s phenomenon: A randomized, controlled study. Clin Exp Rheumatol. 2001;19:503-8.
51. Opitz CF, Wensel R, Winkler J, Halank M, Bruch L, Kleber FX, et al. Clinical efficacy and survival with first-line inhaled iloprost therapy in patients with idiopathic pulmonary arterial hypertension. Eur Heart J. 2005;18:1895-902.
52. Rikitake Y, Liao JK. ROCKs as therapeutic targets in cardiovascular diseases. Expert Rev Cardiovasc Ther. 2005;3:441-51.
53. Fukumoto Y, Matoba T, Ito A, Tanaka H, Kishi T, Hayashidani S, et al. Acute vasodilator effects of a Rho-kinase inhibitor, fasudil, in patients with severe pulmonary hypertension. Heart. 2005;91:391-2.
54. Ishikura K, Yamada N, Ito M, Ota S, Nakamura M, Isaka N, et al. Beneficial acute effects of rho-kinase inhibitor in patients with pulmonary arterial hypertension. Circ J. 2006;70:174-8.
55. Sambo P, Amico D, Giacomelli R, Matucci-Cerinic M, SalsanoF, Valentini G, et al. Intravenous N-acetylcysteine for treatment of Raynaud’s phenomenon secondary to systemic sclerosis: A pilot study. J Rheumatol. 2001;28:2257-62
56. Herrick AL, Hollis S, Schofield D, Rieley F, Blann A, Griffin K, et al. A double-blind placebo-controlled trial of antioxidant therapy in limited cutaneous systemic sclerosis. Clin Exp Rheumatol. 2000;18:349-56.
57. Cookea JP, Marshall JM. Mechanisms of Raynaud's disease. Vasc Med. 2005;10:293-307.
58. Rey J, Cretel E, Jean R, Pastor MJ, Durand JM. Serotonin reuptake inhibitors, Raynaud’s phenomenon and erythromelalgia. Rheumatology. 2003;42:601-2.
59. García-Porrua C, Margarinos CC, González-Gay MA. Raynaud’s phenomenon and serotonin reuptake inhibitors. J Rheumatol. 2004;31:2090.
60. Coleiro B, Marshall SE, Denton CP, Howell K, Blann A, Welsh KI, et al. Treatment of Raynaud’s phenomenon with the selective serotonin reuptake inhibitor fluoxetine. Rheumatology. 2001;40:1038-43
61. Rubin LJ, Badesch DB, Barst RJ, Galie N, Black CM, Keogh A, et al. Bosentan therapy for pulmonary arterial hypertension. N Engl J Med. 2003;346:896-903
62. Denton CP, Humbert M, Rubin L, Black CM. Bosentan therapy for pulmonary arterial hypertension related to connective tissue disease: A subgroup analysis of the pivotal clinical trials and their open-label extensions. Ann Rheum Dis. 2006;65:1336-40.
63. Korn JH, Mayes M, Matucci Cerinic M, Rainisio M, Pope J, Hachulla E, et al. Digital ulcers in systemic sclerosis: Prevention by treatment with bosentan, an oral endothelin receptor antagonist. Arthritis Rheum. 2004;50:3985-93.
64. García de la Peña-Lefebvre P, Rodríguez S, Valero M, Carmona L, Gámir ML, Beltrán J, et al. Long-term experience of bosentan for treating ulcers and healed ulcers in systemic sclerosis patients. Rheumatology. 2008;47:464-6.
65. Morris JL, Jobling P, Gibbins IL. Differential inhibition by botulinum neurotoxin A of cotransmitters released from autonomic vasodilator neurons. Am J Physiol Heart Circ Physiol. 2001;281:H2124-32.
66. Alero F, Ditmars D, Siddiqui A. Botulinum toxin type A: A treatment option for digital ischemia in patients with Raynaud´s phenomenon. J Hist Sex. 2009;34:446-52.
67. Tomaino MM, Goitz RJ, Medsger TA. Surgery for ischemic pain and Raynaud's phenomenon in scleroderma: A description of treatment protocol and evaluation of results. Microsurgery. 2001;21:75-9.
68. Sibell DM, Colantonio AL, Stacey BR. Successful use of spinal cord stimulation in the treatment of severe Raynaud's disease of the hand. Anesthesiology. 2005;102:225-7
69. Park JH, Sung YK, Bae SC, Song SY, Seo HS, Jun JB Ulnar artery vasculopathy in systemic sclerosis Rheumatol Int 2009; 29:1081–6
Cómo citar
1.
Zapata K, García L. Fenómeno de Raynaud. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 4 de marzo de 2019 [citado 18 de abril de 2024];19(4):280-92. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/350
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2019-03-04
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Zapata K, García L. Fenómeno de Raynaud. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 4 de marzo de 2019 [citado 18 de abril de 2024];19(4):280-92. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/350
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