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레이노 현상의 진단적 접근

A Diagnostic Roadmap for Raynaud’s Phenomenon

대한내과학회지 2019년 94권 5호 p.431 ~ 437
최원호 ( Choi Won-Ho ) - 순천향대학교 의과대학 순천향대학교병원 관절류마티스내과

김현숙 ( Kim Hyun-Sook ) - 순천향대학교 의과대학 순천향대학교병원 관절류마티스내과

Abstract


Raynaud's phenomenon (RP) is a reversible vasospasm that is aggravated by cold or emotional stress. Before confirming RP, it is essential to consider other possible causes including compressive neuropathy, sensori-neuropathy, thyroid disease, hematologic conditions and offending drugs. RP is typically characterized by the three-step color change that turns pallor (white), cyanosis (blue), and then erythema (red) of reperfusion. Once RP is diagnosed, it is important to determine whether it is primary or secondary RP. To distinguish primary from the secondary RP, the specialized tests performing in clinical practice are antinuclear antibody (ANA) and nailfold capillary microscopy (NFC). The combination of ANA and NFC is most helpful for discriminating secondary RP due to autoimmune rheumatic disease. Thereby, normal findings of NFC in primary RP distinguished from secondary RP should be understood. Patients with primary RP usually improves with symptomatic treatment focused on lifestyle modification and patient education, but those with secondary RP should be treated together with associated disease or causes.

키워드

레이노 현상; 감별; 항핵항체; 손톱주름 모세혈관경
Raynaud’s phenomenon; Antinuclear antibody; Nailfold capillaroscopy
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