Symptoms of Raynaud's syndrome in patients with fibromyalgia. A study utilizing the Nielsen test, digital photoplethysmography, and measurements of platelet alpha 2-adrenergic receptors

Arthritis Rheum. 1991 Mar;34(3):264-9. doi: 10.1002/art.1780340303.


Twenty-nine female patients with fibromyalgia were questioned about symptoms of cold intolerance and Raynaud's syndrome; objective documentation of cold-induced vasospasm was obtained by a Nielsen test. Twelve patients (41%) had abnormal Nielsen test results, and 11 patients (38%) had elevated levels of platelet alpha 2-adrenergic receptors. There was a positive correlation between the percentage of change in finger systolic pressure on cooling (Nielsen test) and the number of alpha 2-adrenergic receptors. There was poor correlation between Raynaud's syndrome symptoms and an abnormal Nielsen test result. Digital photoplethysmography showed a normal waveform in 2 of 3 patients. We hypothesize that a subgroup of patients with fibromyalgia syndrome have an up-regulation of alpha 2-adrenergic receptors as a cause of their exaggerated reaction to cold.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Blood Platelets / metabolism*
  • Blood Pressure
  • Cold Temperature
  • Female
  • Fibromyalgia / blood
  • Fibromyalgia / complications*
  • Fibromyalgia / physiopathology
  • Fingers / blood supply
  • Humans
  • Middle Aged
  • Plethysmography / methods
  • Raynaud Disease / blood
  • Raynaud Disease / diagnosis
  • Raynaud Disease / etiology*
  • Receptors, Adrenergic, alpha / metabolism*
  • Regional Blood Flow
  • Systole
  • Up-Regulation


  • Receptors, Adrenergic, alpha