title: [Severe Raynaud disease of all four extremities].
abstract: A 64-year-old woman presented with a serious Raynaud's disease affecting all four extremities and resulting in fingertip necroses. The symptoms had initiated after her second pregnancy in association with anorexia requiring treatment in a psychosomatic clinic and necessitating parenteral feeding. After successful sympatholysis a sympathectomy was performed. After initial success a recurrence in the right arm was treated by intraarterial prostaglandin infusion. This treatment brought a temporary benefit whereas intravenous infusions had been without effect. A further medical blockade of the stellate ganglion was followed by a complete disappearance of the symptoms. A subsequent re-operation was performed. Since all the cervical branches of the sympathetic nerve cord had been resected during the first intervention, a partial resection of the stellate ganglion (ganglion cervical inferior) was performed. There was a temporary benefit which lasted a few months. Medical long term treatment was unsuccessful. However, no further necroses occurred and the intermittent pain is tolerable.
authors: Medizinische Klinik, Diakonissenkrankenhauses Mannheim.
authors: C A
authors: CA
authors: Heun-Letsch
authors: H
authors: H
authors: Mörl
mesh_terms: D000527:Alprostadil / Q000008:administration & dosage; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage; D011859:Radiography; D011928:Raynaud Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D012008:Recurrence; D013562:Sympathectomy; D014034:Toes / Q000098:blood supply*; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D010879:Piperazines; D014665:Vasodilator Agents; C015568:urapidil; D000527:Alprostadil
vernacular_title: Schwerer Morbus Raynaud aller vier Extremitäten.