pathology: flammer syndrome

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Definition

Flammer syndrome is a now internationally recognised primary vascular dysregulation syndrome (PVD) that occurs more frequently in women than in men, often from puberty onwards, and is usually first noticed by a tendency to cold armpits on the hands and feet. In addition, many other symptoms can manifest themselves, which can be traced back to vascular dysregulation. Those affected are usually of a slim body type, educated, working in indoor professions and with rather low blood pressure. Mentally, they are usually ambitious, exact to perfectionist people with a certain self-demanding and physically and psychologically sensitive nature. They are often sporty, in line with their general motivation. A slim to very slim constitution and a tendency to coldness of the acres can be regarded as the two cardinal symptoms of Flammer syndrome.

Vegetatively, they tend to have inadequate vascular responses (insufficient or excessive), which explains most of the many possible symptoms. The retinal vessels are stiffer, the autoregulation of blood flow in the eye is poorer, and the gene expression of the lymphocytes is altered. The coldness of the eyes often occurs as a result of coldness or perceived stress, also in the case of food deprivation, rapid ascent to higher altitudes (altitude sickness). The symptoms usually decrease with age, in women mostly after the onset of menopause. In terms of differential diagnosis, Flammer syndrome differs from Raynaud’s syndrome in that the latter occurs in attacks triggered by stimuli, especially exposure to cold and inadequate ambient temperature or perceived stress with consecutive hyperadrenergic state, and the disturbance of vascularisation of the acras in Raynaud’s is also much more pronounced. The possible complications of Raynaud’s syndrome are also more severe.

People with Flammer syndrome have a reduced tendency to arteriosclerosis, but an increased tendency to normal tension glaucoma or retinopathia centralis serosa. MS and breast cancer appear to favour some of the symptoms of Flammer syndrome.

Cause

unknown

Predisposing

  • Retinopathia pigmentosa (Patermann syndrome)
  • Familial, genetic disposition

Diagnosis

  • Medical history, clinic
  • Nailfold capillary microscopy shows excessive vasoconstriction with cold stimulation
  • Retinal vascular analysis with Fkacker light shows reduced or absent vasodilation of the veins
  • Thermography

Symptome

  • cold hands or feet
  • mental sensitivity
  • arterial hypotension
  • slim physique
  • high motivation
  • increased sensitivity to pain
  • prolonged sleep time
  • reduced thirst
  • pronounced sensitivity to cold
  • sometimes pronounced sensitivity to sensory stimuli, such as olfactory stimuli
  • Increased sensitivity to medication in some cases
  • Tendency to pain syndromes, tinnitus, migraine and muscle tension
  • Tendency to reversible circumscribed white or red discolouration of the skin
  • Shifted circadian rhythm

Complications

  • Normal pressure glaucoma
  • sudden deafness

Therapy

  • Therapy is not usually necessary as long as the symptoms do not require it and no complications occur.
  • Regular but not extreme sport
  • Avoid fasting or malnutrition
  • Avoid triggering stimuli such as cold
  • In case of hypotension: sufficient salt consumption
  • If necessary, Mg and calcium antagonists to improve vascular regulation
  • Control of nocturnal blood pressure, as excessive drops can damage the optic nerve head
  • Regular, adequate sleep
  • Ensure that you drink a sufficient amount of fluids

DD