Lim Mie Jin, Kwon Seong Ryul, Kim Sang Gu, Park Won
Inha University Hospital, Incheon, South Korea.
Rheumatol Int. 2009 Apr;29(6):685-8. doi: 10.1007/s00296-008-0717-2. Epub 2008 Oct 11.
Raynaud's phenomenon is characteristic three-phase color change of digits that occurs when hands are exposed to cold and subsequently rewarmed. Raynaud's phenomenon has many possible causes, but evaluation tends to focus on a few notorious etiologies, such as, connective tissue diseases. Thus, having reached a diagnosis, detailed physical exam to rule out other possible causes is often not performed. The authors present a case of mixed connective tissue disease (MCTD) and Takayasu's arteritis overlap in a woman, who showed Raynaud's phenomenon as an initial manifestation. She was first diagnosed as having MCTD, but her treatment did not improve the persistent Raynaud's phenomenon. Several years later, follow-up chest CT showed underlying Takayasu's arteritis and a subsequent physical examination revealed that typical abnormalities consistent with Takayasu's arteritis were present. The authors advocate thorough history taking and complete physical examinations on a routine basis to help unearth other underlying causes.
雷诺现象是指手部暴露于寒冷环境后再复温时，手指出现特征性的三相颜色变化。雷诺现象有许多可能的病因，但评估往往集中在一些臭名昭著的病因上，比如结缔组织病。因此，一旦做出诊断，通常不会进行详细的体格检查以排除其他可能的病因。作者报告了一例女性患者，其患有混合性结缔组织病（MCTD）与大动脉炎重叠，最初表现为雷诺现象。她最初被诊断为MCTD，但治疗并未改善持续存在的雷诺现象。几年后，胸部CT随访显示存在潜在的大动脉炎，随后的体格检查发现了与大动脉炎一致的典型异常。作者主张定期进行全面的病史采集和完整的体格检查，以帮助发现其他潜在病因。
