Raynaud-Syndrom

O. Sander; C. Dechant; M. Czihal

doi:10.1055/s-0038-1660909

Arthritis und Rheuma, Table of Contents

Arthritis und Rheuma 2018; 38(03): 195-201
DOI: 10.1055/s-0038-1660909

Rheuma – vom Symptom zur Diagnose

Schattauer GmbH

Raynaud-Syndrom

Raynaud’s syndrome

Authors

O. Sander

¹Poliklinik für Rheumatologie und Hiller Forschungszentrum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
C. Dechant

²Rheumaeinheit, Klinikum der Universität München LMU, München
M. Czihal

³Angiologie, Klinikum der Universität München LMU, München

Abstract

Zusammenfassung

Das Raynaud-Syndrom ist eine durch Kälte oder Stress ausgelöste reversible Entfärbung der Akren, typischerweise einzelner Finger, durch einen Vasospasmus. Etwa 6 % der Bevölkerung sind betroffen, Frauen häufiger als Männer. Gesichert wird ein Raynaud-Syndrom durch die typische Anamnese und klinische Untersuchung. Bei 80 % der Betroffenen ist von einem primären Raynaud-Syndrom auszugehen. Insbesondere bei spätem Beginn und ausgeprägter Symptomatik kann ein sekundäres Raynaud-Phänomen vorliegen. Hierfür sind viele mögliche, oft seltene Ursachen beschrieben. Die Differenzialdiagnostik bedarf einer detaillierten Anamnese und Untersuchung. Die wichtigsten Instrumente bei Verdacht auf eine entzündlich rheumatische Erkrankung sind Antinukleare Antikörper und die Kapillarmikroskopie. Sind beide unauffällig, ist die Wahrscheinlichkeit sehr gering. Bei Nachweis spezifischer Autoantikörper oder kapillarmorphologischer Veränderungen werden Verlaufskontrollen empfohlen. Der Gefäßultraschall ist die am häufigsten genutzte angiologisch technische Diagnostik.

Summary

Raynaud’s syndrome is a cold- or stressinduced reversible discoloration of the acres, typically of single fingers, through vasospasm. About 6 % of the population is affected, women more often than men. Raynaud’s syndrome is confirmed by the typical history and clinical examination. 80 % have a primary Raynaud syndrome. Especially a late onset and pronounced symptoms is to be expected from a secondary Raynaud phenomenon. For this many possible but rare causes are described. Differential diagnosis requires a detailed history and examination. The most important tools in suspected inflammatory rheumatic disease are antinuclear antibodies and capillary microscopy. If both are inconspicuous, the probability is very low. If specific autoantibodies or capillary morphological changes are detected, follow-up is recommended. Vascular ultrasound is the most commonly used angiological approach.

Schlüsselwörter

Raynaud-Syndrom - Antinukleare Antikörper - Kapillarmikroskopie

Keywords

Raynaud’s syndrome - antinuclear antibodies - capillary microscopy

Full Text

References

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