Terreri M T, Andrade L E, Puccinelli M L, Hilário M O, Goldenberg J
Department of Pediatrics, Sao Paulo Federal University, Escola Paulista de Medicina, Brazil.
Semin Arthritis Rheum. 1999 Aug;29(1):36-42. doi: 10.1016/s0049-0172(99)80036-5.
Capillaroscopy is a simple diagnostic method that permits noninvasive in vivo study of the capillary network. Studies designed to standardize capillary normality in children are limited. This article presents the capillaroscopic findings in healthy children and adolescents, thus making the application of this methodology viable for patients in this age range.
Healthy children were recruited from a private elementary school and junior high school. Nail fold capillaroscopy was performed using a stereomicroscope at 16 times magnification, addressing the following parameters: capillary morphology, capillary enlargement, devascularization, microhemorrhage, and subpapillary venous plexus visibility (PVS). These parameters were related to age, sex, ethnicity, and local periungal conditions.
The sample comprised 329 individuals with mean age of 8.2 years. We observed atypical capillary morphology in 118 of the studied cases (36%), mainly bizarre capillaries in 90 (27%), meandering capillaries in 32 (10%), and bushy capillaries in 20 (6%). The enlarged capillary phenomenon was uncommon, being observed in 30 cases (9%). The number of capillaries per millimeter varied from five to nine. Deletion areas were detected in only seven individuals (2%). The subpapillary venous plexus was not visualized in 13 (4%) cases. Younger children presented higher PVS scores and fewer capillaries/mm as compared with older children. PVS scores were lower in males and in nonwhite children. Other variables were not associated with sex or ethnicity.
The normal nail fold capillary network in children resembles that observed in adults with some differences, such as a lower number of loops per millimeter, a higher PVS score, and a higher frequency of atypical loops. This information is important for the diagnostic evaluation of children in the context of autoimmune rheumatic diseases.
毛细血管镜检查是一种简单的诊断方法，可对毛细血管网络进行无创体内研究。旨在规范儿童毛细血管正常情况的研究有限。本文介绍了健康儿童和青少年的毛细血管镜检查结果，从而使该方法在这个年龄范围的患者中切实可行。
从一所私立小学和初中招募健康儿童。使用放大16倍的体视显微镜进行甲襞毛细血管镜检查，观察以下参数：毛细血管形态、毛细血管扩张、血管减少、微出血以及乳头下静脉丛可见性（PVS）。这些参数与年龄、性别、种族和局部甲周情况相关。
样本包括329名个体，平均年龄8.2岁。我们在118例研究病例（36%）中观察到非典型毛细血管形态，主要是奇异毛细血管90例（27%）、迂曲毛细血管32例（10%）和丛状毛细血管20例（6%）。毛细血管扩张现象不常见，仅在30例（9%）中观察到。每毫米毛细血管数量从5条到9条不等。仅在7名个体（2%）中检测到缺失区域。13例（4%）未观察到乳头下静脉丛。与年龄较大的儿童相比，年龄较小的儿童PVS评分较高且每毫米毛细血管数量较少。男性和非白人儿童的PVS评分较低。其他变量与性别或种族无关。
儿童正常的甲襞毛细血管网络与成人相似，但存在一些差异，如每毫米袢数较少、PVS评分较高以及非典型袢的频率较高。这些信息对于自身免疫性风湿疾病背景下儿童的诊断评估很重要。
