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What is Raynaud’s disease? Raynaud’s disease is a disorder that affects the blood circulation, principally in the fingers and toes but sometimes in the ears, nipples, knees or nose.  It is characterised by a vasospasm – sudden constrictions of the blood vessels that considerably reduce the blood flow to the extremities – most often triggered by an exposure to cold but also by emotional stress. It can exist as an isolated  condition (primary Raynaud’s disease), in which case it is observed more frequently in women and people living in colder climates. The exact cause of primary Raynaud’s disease is not known.      Raynaud’s disease also occurs in men and women with autoimmune diseases, diseases of the conjunctive tissue and also other diseases, most notably:  Systemic scleroderma  Disseminated lupus erythematosis Sjögren’s disease  Rheumatoid polyarthritis  Polymyositis  Pulmonary hypertension Buerger’s disease (thromboangiitis obliterans) In these cases one speaks of secondary Raynaud’s disease. What are the risk factors?  Although we don’t know why certain persons develop Raynaud’s disease, certain risk factors are known:  Pre-existing connective tissue Autoimmune disease Smoking Repetitive pressure exercised on the hands, by using vibrating tools for example (electric tools)  Injuries or traumas Exposure to chemical products Side effects of certain medicines (beta blockers)  Etc. Symptoms and diagnosis There are some very frequent symptoms encountered in Raynaud’s disease patients but each patient can experience different symptoms. The fingers and toes turn white, then blue – generally after having been exposed to cold air or cold objects, or after having suffered stress – and then turn red when warmed up again. In serious cases, sores develop at the ends of the fingers or toes. In rare cases the fingers or toes can become infected or gangrenous, requiring amputation in the absence of treatment.  How to diagnose Raynaud’s disease ? Patients in our medical clinic are initially assessed by a rheumatologist and, depending on the severity, they can also be examined by a vascular specialist.  A large part of the diagnosis will focus on assessing the symptoms. In addition to a complete medical history and a medical examination, our team will generally order at least one type of blood test. A patient may also undergo a cold provocation test to highlight the colour changes in the hands or feet. With secondary Raynaud’s disease it is also important to identify - and treat- the underlying autoimmune disease that may be at the origin of the Raynaud’s disease (for example systemic sclerodermia: see the Erasmus Hospital’s systemic sclerodermia reference centre).  An examination by capillaroscopy is carried out. This non-invasive and painless examination makes it possible to visualise the capillaries in the nail bed. In the case of secondary Raynaud’s disease, as in the case of systemic sclerodermia, a reduction in the number of capillaries is observed as well as  the presence of dilated capillaries.       Treatment After an in-depth evaluation the team of doctors will draw up a treatment plan based on the type and extent of the disease, the general health status of the patient and the patient’s preferences.   Although there is no cure for Raynaud’s disease, it can normally be managed with appropriate treatment, such as:  Lifestyle changes: Limit exposure to the cold by dressing warmly: gloves, socks, scarf, hat and several layers  Stop smoking to improve circulation and your health in general Avoid the use of vibrating tools. Medical treatment Alpha blockers suppress the response of the sympathetic nervous system that leads to vasoconstriction (narrowing of the blood vessels)  Other medicines improve the blood flow to the fingers and toes by dilating the blood vessels. These include  calcium channel inhibitors and phosphodiesterase  inhibitors. Avoid using beta blockers, generally used for treating high blood pressure and that slow the heart rate and reduce the blood flow to extremities For patients who do not show a sufficient response to the aforementioned medicines there can be experimental medicine options - medicines that can be used in clinical trials. 

On Thursday 20 February 2025, the ‘Red Blood Cell’ group of the Belgian Haematology Society and the H.U.B. are organising the next Red Blood Cell Day. Discover the programme and the speakers.  Program & speakers This event will take place at the Jules Bordet Institute, Rue Meylemeersch 90, 1070 Anderlecht, in the Tagnon Auditorium, 1st FloorSession for healthcare professionals09h00Eosinophils and SCD : Bad couple ?S. Karimi (HUB - Brussels)09h30Sickle Cell NephropathyV. Labarque (KUL - Leuven)10h00Vaccination in SCD - What is a realistic approach ?M. Hoyoux (CHU Liège - Citadelle)10h30Coffee Break 10h50Immunological and Practical Aspects of Transfusion in HemoglobinopathiesV. Deneys (CUSL - UCL - Brussels)11h20Transfusional Optimization in Transfusion-Dependent ThalassemiaG. De Luna  (Henri Mondor -APHP - Paris)11h50HSCT in Hbpathies : New regimens versus new therapiesF. Bernaudin (CHIC - Paris)12h20Cerebrovascular workup in SCDB. Biemond (UMC - Amsterdam)13h00Lunch 14h00Diagnostic pitfalls and New Therapies in RBC EnzymopathiesF. Galacteros (Henri Mondor -APHP - Paris)14h30Clinical reesearch in remote region - Experience in DRCB. Mbiya (Centre Mashi - Mbujimayi)15h00Systemic racism vs Care : A sickle cell perspectiveM. Shema (UMF lasi)15h30Pain at Home - Evolution of pain after hospital dischargeL. Vinguetama-Périanagom (ULB - Brussels)16h00Alternatives to opioïd analgesiaC. Greco (Necker-Enfants Malades - APHP - Paris)16h30Coffee Break Session for patients16h45Non-opioid analgesicsS. Hatton (Necker-Enfants Malades - APHP - Paris)17h15NutritionV. Hannecart (HUB - Brussels) & K. Egberts DrepaCoach17h45Access to healthcare and the stay or return of sick peopleS. Jassogne & K. Vanhees - Medimmigrant asbl18h45End of the event  Inscription - Professionnels de santé Inscription - Patients En collaboration avec

Why request a second opinion at the Erasmus Hospital? Above all else, requesting a second opinion is a choice. Everybody is entitled to request a second medical opinion for support and reassurance regarding their treatment.  Also, not all doctors and hospitals necessarily have the expertise, experience and/or equipment required to treat your pathology.   As a university hospital, the Erasmus Hospital gives pride of place to research and teaching and remains at the forefront of scientific research. As a result, when all conventional treatment options have been attempted, there sometimes remain possibilities at the Erasmus Hospital to benefit from innovative treatment in the framework of clinical trials.  What procedures to follow when requesting a second opinion? Whenever possible it is preferable to obtain a copy of your medical records from your GP. This is clearly important so that the Erasmus Hospital can give a second opinion on the basis of all the available information and not repeat examinations and visits unnecessarily.  Specifically, patients should request a complete copy of medical records  from their original doctor and/or hospital. These have a legal obligation to provide the patient with these records within 15 days or to send them to the doctor of the patient’s choice. Some information is shared between Belgian hospitals through Brussels Health Network for the exchange of medical information. Patients must give their written and signed permission to the hospitals involved in this exchange.  Image Contacting the Erasmus Hospital In practical terms, patients can contact the department of their choice depending on the problem encountered.   Services Together we are stronger. Requesting a second opinion is a way of taking a fresh look at your care options. So don’t hesitate to contact us for guidance on your care pathway. 

What is a respiratory allergy? A blocked or running nose, itching eyes, sneezing, night cough, breathing problems... Whether chronic, persistent or seasonal, these symptoms can be the sign of a respiratory allergy (such as hay fever) and/or an asthma of allergic origin. Not all cases of asthma or rhinitis are attributable to an allergy. However, it is important to know whether or not this is the case as this will determine the choice of treatment, its effectiveness and even certain reimbursements!  Care The H.U.B’s Asthma and Allergic Diseases Clinic offers diagnosis and treatment for persons with these diseases or who present respiratory or skin symptoms of the allergic type.    Diagnosis and follow up   First consultation: The person is seen by a pneumologist who notes the symptoms, their frequency and the moments and circumstances in which they appear. The doctor will also carry out a spirometry test which is a simple test that measures the respiratory function. A prick test is also carried out to identify the allergen(s) responsible for the symptoms. This skin test involves placing a drop of the allergen on the arm and then pushing it beneath the epidermis using a fine needle.  The patient should also have a blood test the same day at the Testing Centre. There is no need to fast. In all cases the doctor will already be able to diagnose treatment to relieve the symptoms.    Tests for asthma: if asthma is suspected,  If the respiratory test shows a bronchial obstruction, a bronchodilatation test is carried out immediately;    If the respiratory function is normal, the person is asked to return for a bronchial provocation test using histamine. Carried out under medical supervision, this test makes it possible to either rule out or confirm asthma with quasi certainty.    Second consultation : 6 to 8 weeks later, the patient returns for a consultation.  Aims: to assess the response  to the symptomatic treatment and to discuss the blood test results and other treatment that could be considered.    Follow-up consultations : Once the asthma or respiratory allergy is under control, follow up is proposed at a frequency that depends on the severity of the condition.    Good to know: Depending on the case and needs, the H.U.B.’s Asthma and Allergic Diseases Clinic proposes joint consultations. This enables patients to see  a pneumologist and ENT specialist at the same time or, in the case of a skin allergy, a pneumologist and dermatologist.    Persons with asthma can also benefit from treatment education programmes at the  School of Asthma. Treatment Treatment for a respiratory allergy depends both on the allergens in question and the symptoms.    Symptomatic treatment includes antihistamines taken orally, corticoid-based nasal sprays and eye drops.     Immunotherapy consists of modifying the immune response of the patient, causing it to evolve from an allergic status to a tolerance status in regard to the allergen.   Immunotherapy often involves taking tablets that melt on the tongue or otherwise drops. This treatment is effective but it is relatively long and costly. It is only reimbursed if the asthma is caused by an allergy to dust mites and associated with a dust mite allergic rhinitis.      Asthma treatment (bronchodilatators, anti-IgE, anti-interleukins, biological treatment, etc.) is varied and  depends on the type of asthma. As the illness varies over time, the treatment must be adapted accordingly.    Advice Treatment by avoidance is always recommended in the case of allergies. This involves avoiding as much as possible exposing oneself to allergens or applying certain measures to reduce to the maximum exposure to the allergens. For example: washing sheets at 90°C; airing rooms in winter when it is cold; in the case of allergy to dust mites, closing the windows when pollen is at a peak (allergies to grains and other pollens), etc.    Image Research The main line of translational research pursued by the H.U.B’s Asthma and Allergic Diseases Clinic concerns inflammation of the lower respiratory tract (bronchi). Doctor  researchers work on the use of exhaled NO to guide immunotherapies and biological therapies as well as on induced expectorated sputum as a means of identifying the phenotype of an asthma and to guide treatment.    Related service Related doctors

Our role This multidisciplinary team of healthcare staff exercising different professions aims to ensure continuity of care at the Erasmus Hospital and externally when the patient approaches end of life or requires symptomatic treatment, notably to manage pain and uncomfortable symptoms such as nausea, vomiting, hiccups, constipation, etc. Our mobile team is available on request for the care team, patient and patient’s family.    Image Our specialities Our team consists  of liaison psychiatrists, internists, nurses, psychologists, physiotherapists, dietitians, pharmacists and social workers.  Their missions are to give timely and/or repeated opinions without assuming direct responsibility for the patient, to offer support to those around the patient and the care teams, to prepare for discharge, return home or transfer to another institution or rest home in close cooperation with the family GP and the required outpatient assistance and care structures. All team members listen to the patient, possibly provide advice and increase the awareness of all the interlocutors while respecting their individual philosophical convictions and religious beliefs. The joint approach to a patient with a serious, progressive and incurable illness must be centred around respect for autonomy while seeking to guarantee as much as possible the remaining quality of life and comfort.     Useful links Fédération Bruxelloise de Soins Palliatifs (FBSP)  Association pluraliste de soins palliatifs de la région de Bruxelles (Palliabru) : +32 (0)2 743 45 92