Bansal Ciara J, Kamel Kirollos
Rheumatology, Haematology, Royal Melbourne Hospital, Melbourne, AUS.
Haematology, Royal Melbourne Hospital, Melbourne, AUS.
Cureus. 2023 Jan 14;15(1):e33781. doi: 10.7759/cureus.33781. eCollection 2023 Jan.
Acute SARS-CoV-2 infection is associated with several cutaneous manifestations, including vasculitic digital ischemia. The reversal of digital ischemia in the primary Raynaud phenomenon (RP) arises from endothelial hypersensitivity to circulating adrenaline and noradrenaline and diminished vasodilatory innervation. SARS-CoV-2 can infect endothelial cells and be associated with raised adrenaline levels, reduced microvascular dilatory responses, and exaggerated clotting mechanisms. We report worsened RP in a patient with previously mild winter-time primary RP during the periods of fever and rigors from an acute SARS-CoV-2 infection contracted in a warm summer period. This reverted to the mild phenotype after recovery, and we discussed possible mechanisms for the brief exacerbation.
新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）急性感染与多种皮肤表现相关，包括血管炎性指端缺血。原发性雷诺现象（RP）中手指缺血的逆转源于内皮细胞对循环中的肾上腺素和去甲肾上腺素高度敏感以及血管舒张神经支配减弱。SARS-CoV-2可感染内皮细胞，并与肾上腺素水平升高、微血管舒张反应降低以及凝血机制亢进有关。我们报告了一名既往冬季原发性RP症状较轻的患者，在温暖的夏季感染急性SARS-CoV-2后，在发热和寒战期间RP症状加重。康复后恢复为轻度表型，我们讨论了这种短暂加重的可能机制。
