Raynaud's phenomenon and lupus: Causes and symptoms

Problems with cardiovascular system causes Raynaud's phenomenon among people with lupus, appearing in approximately one-third of cases.

What's Raynaud's phenomenon? 

French physician Maurice Raynaud first discovered Raynaud’s phenomenon in a young woman in 1862. With Raynaud’s the small blood vessels in extremities are over-sensitive to temperature variations. This triggers Raynaud’s attack which causes fingers change color from white, to blue, to red. Sometimes attack also causes pain in fingers or a tingling sensation. These symptoms can last from few to minutes to several hours.

“My hands in particular can be so bad I can’t go into a shop with air conditioning or get something out of the fridge (I have to wear thermal gloves for the freezer). Over the last couple of years my nose is suffering a lot.”

“Sometimes simply holding metal cutlery will set my hands off, or walking down a supermarket freezer aisle!”

Link between Raynaud’s phenomenon and lupus

When faced with cold temperatures, the nerves of the skin, blood vessels, and brain sense the colder temperature and then send messages along the nervous system to the arteries of skin, hands, and feet to contract to keep as much warm blood as possible away from the skin, hands, and feet. This preserves body’s vital warmth to keep the blood and inner vital organs of the body such as heart, kidneys at the correct warm body temperature. In most of cases, this process causes the skin to feel cooler than normal.

With Raynaud’s flow of blood to extremities becomes so restricted that it less reaches to hands and feet. This low blood flow causes fingers and toes may become pale and colder than normal. Then tissues and cells use up oxygen and release carbon dioxide into the blood, this normally turns red blood to blue or purple. With the rise in temperature, fresh blood flows in and color may turn reddish.

Inflammation from lupus may cause the restricted blood flow in Raynaud’s. Inflammation causes the walls of the arteries to become thicker and therefore arteries in extremities have narrow space through which blood can flow.

Potential complications of lupus

In certain cases tissues of fingertips may lose nutrients and oxygen after repetitive episodes. The fleshy parts of fingers may lose tissue and become thin over time. Under severe condition tissue may actually die due to the lack of nutrients and oxygen. This can contribute to the development of open sores. These can be very painful and are prone to infection if not treated.

“I suffer badly with this in my hands and feet and have had severe chilblains on my toes in the winter since I was a teenager.”

The fact that Raynaud’s usually results from thickened blood vessel walls caused by previous inflammation makes it a permanent problem. Therefore, Raynaud’s does not get better with the use of anti-inflammatory medicines such as steroids and immunosuppressant medicines. Raynaud’s usually remains stable between lupus flares and remissions.

Secondary Raynaud’s (when it’s caused by another health condition, such as lupus) can severely restrict the blood supply, so it carries a higher risk of complications, such as ulcers, scarring and even tissue death (gangrene) in the most serious cases. However, severe complications are rare