Multidisciplinary Treatment for Severe Secondary Raynaud’s Phenomenon: A Case Report

Cuibo Leng; Guanjun Lin; Hong Cao; Zijia Liu

doi:10.24920/004078

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Multidisciplinary Treatment for Severe Secondary Raynaud’s Phenomenon: A Case Report

Chinese Medical Sciences Journal Vol. 37, Issue 4, Pages: 353-358(2022)

Case Report | Updated：2024-04-10

- Multidisciplinary Treatment for Severe Secondary Raynaud’s Phenomenon: A Case Report
- Affiliations：
  
  1. 1Department of Anesthesiology, Affiliated Qingdao Central Hospital of Qingdao University & Second Affiliated Hospital of Medical College of Qingdao University, Qingdao, Shandong 266042, China
  2. 2Department of Cardiovascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, China
  3. 3Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
  
  * 86-18501155710, E-mail: liu-zj02@126.com
- Funds：
- DOI：10.24920/004078
  CLC：
- Received：05 February 2022，
  
  Accepted：2022-4-19，
  
  Published Online：26 April 2022，
  
  Published：31 December 2022
- Accepted：
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Cuibo Leng, Guanjun Lin, Hong Cao, et al. Multidisciplinary Treatment for Severe Secondary Raynaud’s Phenomenon: A Case Report[J]. Chinese medical sciences journal, 2022, 37(4): 353-358.
DOI：

Cuibo Leng, Guanjun Lin, Hong Cao, et al. Multidisciplinary Treatment for Severe Secondary Raynaud’s Phenomenon: A Case Report[J]. Chinese medical sciences journal, 2022, 37(4): 353-358. DOI： 10.24920/004078.

摘要

雷诺现象是指在寒冷或其他交感刺激因素的诱发下，出现间歇性指端缺血的特征性病变。继发性雷诺现象通常症状更为严重，甚至可导致指端溃疡，治疗也尤为复杂。我们报道了1例65岁女性因继发于亚临床甲状腺功能减退而出现严重的继发性雷诺现象，发作持续时间超过6小时。患者合并有甲状腺功能减退、癫痫、右中指及环指继发性软组织感染。经过多学科会诊与讨论，通过扩张血管、抗凝、甲状腺素替代、星状神经节阻滞、高压氧治疗及清创术等综合治疗，患者顺利康复，避免了截肢和明显的指端功能障碍。多学科诊疗模式(MDT)集合了各学科的专科力量，能为严重继发性雷诺现象患者提供最优治疗策略，可有效改善继发性雷诺现象患者的预后和满意度。

Abstract

Raynaud’s phenomenon is a symptom complex manifested as intermittent fingertip ischemia caused by cold or other sympathetic drivers. Secondary Raynaud’s phenomenon is often more severe and could even lead to finger ulceration

making it particularly complicated to treat. We describe a case of severe Raynaud’s phenomenon secondary to subclinical hypothyroidism lasting for more than 6 hours in a 65-year-old woman. The patient was also diagnosed with hypothyroidism

epilepsy

and secondary soft tissue infection of the right middle and ring fingers. After careful multidisciplinary consultation and discussion

the patient received vasodilation

anticoagulation

thyroxine supplementation

stellate ganglion block

hyperbaric oxygen therapy and debridement. The patient responded well to the medication

avoiding amputation or obviously dysfunction. Multidisciplinary team gathering the doctors from different departments proposes appropriate strategies for patients with severe Raynaud’s phenomenon and could improve the prognosis and satisfaction of patient effectively.

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references

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