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Does she have a hx of cold injury (frostbite)?
 
Chris Willis RVT
Coordinator
Vascular Laboratory
Eastern Maine Medical Center
Bangor, Maine 04401
Phone:  (207) 973-7471
Fax:  (207) 973-7450

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From: UVM Flownet on behalf of Jodi Zannino
Sent: Wed 1/20/2010 1:38 PM
To: [log in to unmask]
Subject: 5 yrs old with Raynaud's





Hello All,
I had an interesting case this am. A 5yr old girl , yes 5, with symptoms of discolored upper and sever lower extremity digits. Now has sores on the 3rd toe, bilaterally R>L.  She was recently treated for Lyme's.  The patient also lives in an old farm house- wood flooring and does not wear socks or slippers in house. This is the northeast and as you all know....it's been a cold winter so far!
The order was for Raynaud's of the lower extremity as they are the most symptomatic and she was referred by a podiatrist. The Brachial pulses were normal with normal pressures bilaterally(and ankles too). 
Normal bilateral TBI's. PPG waveforms in the bilateral lower extremity digits were either normal or vasospasm in appearance (R>L) throughout. 
I'm thinking this is some kind of autoimmune disease causing this. Have any of you seen a patient so young with this presentation? What are your thoughts? 
I welcome your input?
Thanks,
 
JZ, RVT
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