Rorah Drayton J, Daghlas Salah, Badshah Mashood, Schmidt Paul, Maz Mehrdad
Internal Medicine, University of Kansas Medical Center, Kansas City, USA.
Division of Allergy, Clinical Immunology, & Rheumatology, University of Kansas Medical Center, Kansas City, USA.
Cureus. 2024 Nov 21;16(11):e74144. doi: 10.7759/cureus.74144. eCollection 2024 Nov.
Primary Raynaud's phenomenon (RP) is a common and self-limiting condition, which is not secondary to any other disease process. In contrast, secondary RP has an underlying etiology. Several conditions can lead to secondary RP, which creates a challenging landscape for clinicians. Differentiation between primary and secondary RP is vital as failure to do so can lead to delays in treatment and poor patient outcomes. We present a case of a 77-year-old male who experienced digit discoloration when exposed to cold temperatures. He had been initially diagnosed with primary RP, but his symptoms had increased in frequency and progressed to digit necrosis requiring amputation. He was admitted to our tertiary care center for further workup. Subsequently, a diagnosis of type I cryoglobulinemia secondary to lymphoplasmacytic lymphoma (LPL) was made instead of the initial diagnosis of primary RP as the cause of his digit necrosis. This report emphasizes the importance of differentiating between primary and secondary RP and highlights the need for comprehensive workup in patients with RP, especially those presenting with atypical features.
原发性雷诺现象(RP)是一种常见的自限性疾病,并非继发于任何其他疾病过程。相比之下,继发性RP有潜在病因。多种情况可导致继发性RP,这给临床医生带来了挑战。区分原发性和继发性RP至关重要,因为未能做到这一点可能导致治疗延误和患者预后不良。我们报告一例77岁男性,其在暴露于寒冷温度时出现手指变色。他最初被诊断为原发性RP,但症状频率增加并进展为手指坏死,需要截肢。他被收治到我们的三级医疗中心进行进一步检查。随后,诊断为继发于淋巴浆细胞淋巴瘤(LPL)的I型冷球蛋白血症,而非最初诊断的原发性RP是其手指坏死的原因。本报告强调了区分原发性和继发性RP的重要性,并突出了对RP患者进行全面检查的必要性,尤其是那些具有非典型特征的患者。