Difficulties in diagnosis and treatment of severe secondary Raynaud’s phenomenon in a Cameroonian woman: a case reportReport as inadecuate




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Journal of Medical Case Reports

, 10:356

First Online: 20 December 2016Received: 03 October 2016Accepted: 09 November 2016DOI: 10.1186-s13256-016-1142-x

Cite this article as: Agbor, V.N., Njim, T. & Aminde, L.N. J Med Case Reports 2016 10: 356. doi:10.1186-s13256-016-1142-x

Abstract

BackgroundRaynaud’s phenomenon is a microvascular disorder that results in exaggerated vasoconstriction over vasodilatation secondary to an alteration in autonomic control. Though benign, it can result in severe ulceration and ultimately gangrene associated with disfiguration and permanent deformity. We present a case of severe secondary Raynaud’s phenomenon in a black-African patient from a resource-limited setting, with focus on the difficulties encountered in the diagnosis and treatment.

Case presentationA 43-year-old female Cameroonian farmer with a 7-year history of episodic paresthesia in her fingers and toes when exposed to cold presented to our emergency department with severe pain, ulceration, and -darkening- of her fingertips over a period of 2 days. An examination revealed bilateral ulceration and dry gangrene of her fingers and toes, based on which a diagnosis of secondary Raynaud’s phenomenon due to a connective tissue disease was proposed. Results of paraclinical investigations were normal. Lifestyle modification along with a calcium channel blocker and phosphodiesterase type 5 inhibitor provided significant relief.

ConclusionsAn early diagnosis and knowledge on appropriate treatment of Raynaud’s phenomenon is of vital importance to prevent permanent tissue damage and disability. Relying on biphasic color change for the diagnosis of Raynaud’s phenomenon in black Africans can be potentially misleading.

KeywordsSecondary Raynaud’s phenomenon Connective tissue disease Cameroon AbbreviationsANAAnti-nuclear antibodies

ASLOAnti-streptolysin O antigen

CCBsCalcium channel blockers

CRESTCalcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia

ESRErythrocyte sedimentation rate

PG E2prostaglandin E2

RPRaynaud’s phenomenon

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Author: Valirie Ndip Agbor - Tsi Njim - Leopold Ndemnge Aminde

Source: https://link.springer.com/







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