Raynards type 3

[amandajane76]

By all accounts I have raynards type 3.never heard of this grouping

[lupus-support1 Administrator]

Who gave you this diagnosis? Did you ask them to explain what this means?

See: patient.info/doctor/raynaud...

Raynaud's phenomenon occurs when the extremities of the body, usually the fingers and toes, change colour and may become painful. It is due to a narrowing (constriction) of the small blood vessels on exposure to the cold, or to a change in temperature, or to emotional stress. In most cases, the cause is not known. In some cases, it is a symptom of an underlying condition such as scleroderma, lupus, or rheumatoid arthritis. The main treatment is to keep warm. Medicines to open up the blood vessels are used in some cases.

What is Raynaud's phenomenon?

Raynaud's phenomenon, often just called Raynaud's, is a condition where the small blood vessels of the fingers become narrow (constrict), most commonly when they are in a cool environment. Sometimes blood vessels to other extremities such as the toes, ears and nose are affected. It is named after Dr Maurice Raynaud, the man who first described it in 1862.

What are the symptoms of Raynaud's?

Typically, symptoms develop in fingers when you become cool - for example, in cold weather.

At first the fingers go white and cool. This happens because the small blood vessels in the fingers narrow (constrict).

The fingers then go a bluish colour (or even purple or black in severe cases). This happens because the oxygen is used up quickly from the blood in the narrowed blood vessels.

The fingers then go bright red. This happens because blood vessels open up again (dilate) and the blood flow returns. This may cause tingling, throbbing, numbness and pain (which can be severe in some cases).

RAYNAUD'S PHENOMENON

Many people with Raynaud's do not have the full classic colour changes, but develop bouts of uncomfortable, pale, cold fingers. Only the fingers are affected in most cases. In some cases the toes are also affected. Less commonly other extremities of the body are affected, such as the earlobes, nose, nipples or tongue. Each bout of symptoms can last from minutes to hours.

Raynaud's is usually mild, with infrequent, brief bouts of symptoms that last just a few minutes. Sometimes it is moderate with more frequent bouts of symptoms that last longer. Rarely, it is severe with repeated frequent bouts, with each bout lasting longer periods of time.

What causes Raynaud's?

Primary Raynaud's - when the cause is not known

In most cases there is no known cause (more than 9 in 10 cases). This is called primary Raynaud's. The small blood vessels in the fingers, toes, etc, just appear to be more sensitive than normal to cool temperatures. There is no other underlying disease. Symptoms are triggered more easily in some people than in others. Even mildly cool weather, or getting something out of the freezer, can trigger symptoms in some people. Strong emotion may also trigger symptoms in some cases.

Usually, all fingers on both hands are affected in primary Raynaud's. It also tends to run in some families. Women are affected much more often than men. It usually first develops before the age of 30. There are no other symptoms apart from those described above, and symptoms go completely after each bout.

Secondary Raynaud's - due to an underlying cause

In less than 1 in 10 cases, there is an underlying cause. This is called secondary Raynaud's. Various conditions of blood vessels, joints, muscles, nerves or skin can cause secondary Raynaud's. For example, scleroderma, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus (SLE) and other 'connective tissue' diseases.

If you have secondary Raynaud's you will normally have other symptoms in addition to the symptoms of Raynaud's. The Raynaud's is just one feature of the condition. For example, you may also have joint pains, rashes, joint swelling, etc.

Often, the underlying condition is already present, and you may develop Raynaud's as a complication. Sometimes the symptoms of Raynaud's occur first, and other symptoms of the underlying condition develop weeks, months or even years later.

In secondary Raynaud's, symptoms may first begin in just one or two fingers on one hand. This is in contrast to primary Raynaud's when all fingers on both hands are typically affected. Certain medicines may also cause secondary Raynaud's as a side-effect (see below).

Hand-arm vibration syndrome (vibration white finger) is one common cause of secondary Raynaud's. This is caused by using vibrating tools regularly over a long time. For example, it occurs in some shipyard workers, mine workers, road diggers, etc. It is thought that repeated vibrations over time may damage the small blood vessels or their nerve supply.

How common is Raynaud's?

Raynaud's is a common disorder. About 1 in 20 people develop Raynaud's phenomenon. Up to 9 in 10 cases are primary Raynaud's. Primary Raynaud's usually first develops in teenagers and young adults, but it can develop at any age. Secondary Raynaud's can develop at any age when the underlying condition develops.

Do I need any tests to confirm the diagnosis?

Not in most cases. There is no test that confirms primary Raynaud's. The diagnosis of primary Raynaud's is made on the basis of the typical symptoms (described above) and there is no abnormality found that may suggest a secondary cause when a doctor examines you.

Features that may suggest secondary Raynaud's include:

Onset of symptoms after 30 years of age.

Abrupt onset with rapid progression and worsening of symptoms.

Severe symptoms that may include an ulcer or gangrene of part of a finger or toe.

Symptoms that only affect one hand or foot, or the symptoms are not the same or as severe on both hands and feet.

Joint pains or arthritis.

Skin rashes.

Dry eyes or mouth.

Muscle weakness or pain.

Swallowing difficulties.

Breathlessness.

Mouth ulcers.

Previous work with vibrating tools.

Blood tests and other tests may be done if secondary Raynaud's is suspected. Sometimes the diagnosis of an underlying cause is already known (for example, rheumatoid arthritis) and the development of Raynaud's is not a surprising feature.

What are the possible complications of Raynaud's?

Primary Raynaud's - complications seldom, if ever, occur.

Secondary Raynaud's - complications occur in a small number of cases and include ulcers developing on affected fingers and toes; scarring of tips of fingers and toes; tissue death (gangrene) of parts of affected fingers and toes.

[amandajane76 in reply to lupus-support1]

I ve had raynards plus chilblains' annually for years.however more recently I have had worsening erythromelalgia.in a letter from specialist it listed raynards type 3.gp read letter to me but did NT explain.i never heard of different types.

[lupus-support1 Administrator in reply to amandajane76]

Perhaps you need to phone your specialist and ask to explain to you what this means because I have never come across of Type III Raynaud's.

Erythromelalgia is a rare and frequently devastating disorder that typically affects the skin of the feet or hands, or both, and causes visible redness, intense heat and burning pain.

The term erythromelalgia describes the syndrome: erythros (redness), melos (extremity) and algia (pain). An alternate name is “erythermalgia” that emphasizes the thermos (heat) – an essential part of the syndrome.

While usually affecting the lower extremities (legs and feet) and upper extremities (arms and hands) other body parts like faces or just ears or the nose may be involved. It usually affects both sides of the body, but can affect just one.

The associated pain and burning sensations can be extremely severe. People with EM often make major adjustments to their lifestyles to avoid flare-ups. Even in mild-to-moderate cases, normal functioning such as walking, standing, working, socializing, exercising, and sleeping may be impaired.

Precipitating factors include warm temperatures and even mild exercise. Cooling the hot body parts relieves the pain, as does elevating the affected areas. [The use of ice and water soaking is strongly discouraged as ice and water submersion can damage the skin.] The characteristic of cooling bringing relief to EM sufferers pain is a hallmark trait of EM.

Approximately five percent of those with EM have an inherited condition that research has shown to be caused by genetic mutations. These people usually have other members of their families with the syndrome.

The cause of EM is unknown in the vast majority of cases. Peripheral neuropathies underlie many, and in some cases EM may be secondary to other disorders like the blood disease polycythemia.

A number of different medications have been shown effective in relieving symptoms of EM. However, no one drug helps everyone. Traditional over-the-counter pain medications or stronger prescription drugs help some. Anticonvulsant drugs like Neurontin and Lyrica help others. Certain antidepressants like Cymbalta help still others. Combinations of drugs also have been reported effective. For instance, Lyrica and Cymbalta, at the lowest possible dosage, have been reported to be more effective than either drug by itself.

It is recommended that people with EM find a doctor willing to help them pursue a trial-and-error course of treatment. Since some people may be highly sensitive to drugs, initial doses of new medications should be very low.

Recent research in the U.S. found the incidence of EM (the number of people a year diagnosed with EM) to be 1.3 per 100,000. The rate for women was higher – 2.0 per 100,000 per year – than men, which was just 0.6. The median age at diagnosis was 61.

These rates were five times higher than those estimated by an earlier Norwegian study – the only other known research describing EM incidence.

[EOLHPC LUPUS SUPPORT Volunteer]

Am v glad you've posted your ?s & got these good replies. I'm managing simultaneous raynauds & erythromelalgia too (consciously had these together for 10ish years, but had raynauds from childhood with infant onset lupus). I hope you can figure out more about this and hypersensitivity type lll re mctd

PS just found this link on the subject (& others...I googled: mctd type lll hypersensitivity & quite a few good links turned up):

en.m.wikipedia.org/wiki/Typ...

[lupus-support1 Administrator]

Mixed Connective Tissue Disease is a confusing terms because this condition involves several autoimmune conditions at once such as SLE, dermato/polymyositis and scleroderma. According to Dr Graham RV Hughes, an international authority on SLE, MCTD is to all extent and purposes, lupus and should be treated as such ie patients should receive treatment for lupus.

[amandajane76 in reply to lupus-support1]

I say mctd but yet they've had me on plequnil for 14

[lupus-support1 Administrator]

Plaquenil is a standard drug used to treat SLE/lupus. MCTD is treated as lupus, even though a patient may have other connective tissue disease components. because lupus is one of the components.

[tashi]

Really good explanations Ros. I've had Raynaud's for over 30 years, it was a primary condition. It wasn't until I was 50 that I was diagnosed with DLE then just a few months later with SLE ,that it became "secondary " along with thyroid condition etc. Interestingly Rheumy thinks it was likely that I had SLE all along but as other problems came on gradually over the years it was never tested for.

When DLE very visibly appeared as my gp said they really only had to join the dots to spot Lupus. I've been on hydroxychloroquine since dx but have also always needed to take adalat /nifedipine to keep chilblains etc in check.