Clemente Gleice, Piotto Daniela Gerent Petry, Barbosa Cássia, Peracchi Octávio Augusto, Len Claudio Arnaldo, Hilário Maria Odete Esteves, Terreri Maria Teresa R A
Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Rev Bras Reumatol. 2012 Aug;52(4):549-53.
To assess the frequency of calcinosis in patients with juvenile dermatomyositis, and the possible risk factors for that manifestation.
Medical record review of 34 patients, with an emphasis on the following characteristics: demographic, clinical and laboratory data; type of treatment; adherence to treatment; disease course (monocyclic, chronic and polycyclic); and disease severity. Patients were divided into two groups as follows: those who developed calcinosis (up to the sixth month of follow-up and after six months of follow-up) and those who did not develop calcinosis. Twenty-seven patients underwent two nailfold capillaroscopies (NFC), which were considered altered when the scleroderma pattern was found.
The mean age of symptom onset of the 34 patients was 6.5 years, the time until diagnosis was 1.2 years, and 70% were females. Half of the patients had a monocyclic disease course, and only 14.7% had severe vasculitis. Almost 90% of the patients undergoing NFC showed a change on the first assessment, 74% showed a change on the second assessment, and the mean interval between both assessments was 1.6 year. Calcinosis was evidenced in 16 (47.1%) patients. No association was observed between the variables analyzed and the development of calcinosis.
No risk factors for calcinosis were identified in this study, although that complication was found in half of the patients with juvenile dermatomyositis studied.
评估青少年皮肌炎患者钙质沉着症的发生率及其发生的可能危险因素。
对34例患者的病历进行回顾,重点关注以下特征:人口统计学、临床和实验室数据;治疗类型;治疗依从性;病程(单循环、慢性和多循环);以及疾病严重程度。患者分为两组:发生钙质沉着症的患者(随访至第六个月及六个月后)和未发生钙质沉着症的患者。27例患者接受了两次甲襞毛细血管镜检查(NFC),当发现硬皮病样改变时则认为检查结果异常。
34例患者的平均症状起始年龄为6.5岁,确诊时间为1.2年,70%为女性。一半患者病程为单循环,仅14.7%有严重血管炎。接受NFC检查的患者中,近90%在首次评估时有改变,74%在第二次评估时有改变,两次评估的平均间隔时间为1.6年。16例(47.1%)患者出现钙质沉着症。在所分析的变量与钙质沉着症的发生之间未观察到关联。
本研究未发现钙质沉着症的危险因素,尽管在所研究的青少年皮肌炎患者中,有一半出现了该并发症。