The concept of Raynaud's phenomenon of the lung revisited.
ABSTRACT Having observed that a cold pressor test (CPT) induces a decrease in carbon monoxide single breath diffusing capacity (DLco) in normal subjects contrary to the findings of Fahey et al (Am J Med. 1984; 76:263-269), we compared the response to CPT for the two types of Raynaud's phenomenon.
Two groups of 8 patients suffering from primary or secondary Raynaud's phenomenon were examined.
Single breath diffusing capacity, mean pulmonary artery pressure (PAP), cardiac output (CO), pulmonary capillary wedge pressure (PwP), and pulmonary vascular resistance (PVR) were measured before and 30 minutes after CPT, which consisted of immersing both hands in a water bath at 12 degrees C for 2 minutes.
Cold pressor testing induced no change in DLco or cardiovascular parameters in patients with secondary Raynaud's phenomenon. Conversely, in patients with the primary form, it induced a significant decrease in DLco (16%), PAP (20%), and PVR (27%), whereas CO and PwP remained unaltered.
The concept of pulmonary Raynaud's phenomenon had to be reconsidered, as it is also observed in normal subjects, and is due to a vasodilatation and not to a vasoconstriction of the pulmonary artery (Frans et al, J Appl Physiol. 1994; 76:750-755). In patients with primary Raynaud's phenomenon, the decrease in DLco is not only a physiological response, but a pathological response to a CPT, as it is significantly more marked in patients than in control subjects (16% versus 10% for controls, same reference). The contribution by Fahey et al remains important, however, in that it allows assessing whether a patient with Raynaud's phenomenon suffers from the primary or secondary form of the disease.
Article: SCLERODERMA.[Show abstract] [Hide abstract]
ABSTRACT: Scleroderma is a descriptive construct that defines a large family of diseases characterized clinically by thickening of the skin. Systemic sclerosis (SSc) is a complex disease affecting multiple organ systems and is the most representative and prevalent of this spectrum of disorders. Generalized subcutaneous morphea (GSM, morphea profunda) is a form of localized scleroderma that tends to spare the internal organs. We are presenting two cases illustrating the aforementioned clinical entities.Journal of the Indian Medical Association 06/1965; 44:484-6.
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ABSTRACT: Background In type II diabetes mellitus there are few data concerning pulmonary function abnormalities. In normal subjects and in patients with primary Raynaud phenomenon, cold pressor test induces a decrease in carbon monoxide single-breath diffusing capacity (DL,co) but not in secondary Raynaud phenomenon. Our objective was to assess evaluation of lung diffusion capacity postural changes in diabetes mellitus and in secondary Raynaud phenomenon, two diseases with different pulmonary capillaries functional disorders.Archives of Medical Research - ARCH MED RES. 01/2002; 33(6):531-535.
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ABSTRACT: We describe a patient with an episode of severe Raynaud's phenomenon and early or mild scleroderma who presented with a transient elevation of her serum creatinine that resolved spontaneously after 2 days. Vascular response to cold temperatures has been described in vascular beds other than the extremities, and a similar phenomenon in the kidney might have been responsible for the transient renal dysfunction. Possible mechanisms to explain this phenomenon are discussed. Vasospasm merits consideration as an uncommon but largely reversible cause of elevated creatinine in patients with Raynaud's phenomenon.JCR Journal of Clinical Rheumatology 05/2003; 9(2):88-91. · 1.18 Impact Factor