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Case 28 

Case 28
Chapter:
Case 28
Author(s):

Joel David

, Anne Miller

, Anushka Soni

, and Lyn Williamson

DOI:
10.1093/med/9780199587506.003.0028
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date: 23 October 2019

A 26-year-old woman was referred by her GP with an 8-year history of Raynaud’s syndrome. She described several occasions where she had had infected ischaemic ulcers on her feet. She smoked 15 cigarettes a day and was on the combined oral contraceptive pill. She was seen by the registrar, who noted spindled fingers with distal pulp atrophy. Her fingers and toes were cold and had a dusky blue discoloration. Investigations were arranged and she was advised to stop smoking. Her ENA was positive for anticentromere antibody. Lung function tests showed a reduced TLCO of 72%. The chest CT scan was normal, as was an echocardiogram.

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