Martínez-Cordero E, López-Zepeda J, Martínez-Miranda E, Reyes-Salinas A, Negrete-García M C
Bol Med Hosp Infant Mex. 1989 Oct;46(10):641-8.
Five patients with childhood scleroderma, were studied from a total group of 50 cases with the disease, 39 of them with diffuse systemic sclerosis and 11 with the CREST syndrome. The average age for these five patients when the disease onset was 13 (the age ranged from 5.5 to 16 years) with an average follow-up of 3.6 years (ranging from 1 to 6.5 years). Of the five, four girls were classified as having diffuse systemic sclerosis and the remaining boy, as suffering from the CREST syndrome. We found no family history or personal and occupational antecendents related with the appearance of the illness. Also excluded were conditions associated with changes similar to scleroderma as are seen in cases of diabetes mellitus, phenylketonuria, toxic oil syndrome, or graft-host rejection reactions. The clinical manifestations seen at the start of the disease included the Raynaud phenomenon, subcutaneous edema and muscular-skeletal abnormalities as arthralgia and myalgia with objective data of inflammatory myopathy. Proximal scleroderma was seen in all five patients; three of them, in addition, developed rapidly progressive cutaneous changes, causing the loss of elasticity and cutaneous hardening of the face during the first year of the disease. In all of the cases, the skin biopsy showed histopathological changes compatible with the diagnosis already given. The most important changes seen in the organs of these children were oesophageal dysfunction and fibrosis of the lung. The X-rays of three of the patients showed them to suffer from intestinal malfunction. We found no kidney, liver or nervous system disorders.(ABSTRACT TRUNCATED AT 250 WORDS)
在50例儿童硬皮病患者中,对其中5例进行了研究。这50例患者中,39例为弥漫性系统性硬化症,11例为CREST综合征。这5例患者发病时的平均年龄为13岁(年龄范围为5.5至16岁),平均随访时间为3.6年(范围为1至6.5年)。这5例患者中,4名女孩被归类为弥漫性系统性硬化症,其余1名男孩患有CREST综合征。我们未发现与该病出现相关的家族史或个人及职业史。也排除了与硬皮病类似变化相关的疾病,如糖尿病、苯丙酮尿症、有毒油综合征或移植物宿主排斥反应。疾病开始时出现的临床表现包括雷诺现象、皮下水肿以及肌肉骨骼异常,如关节痛和肌痛,并伴有炎症性肌病的客观数据。所有5例患者均出现近端硬皮病;其中3例在疾病的第一年还出现了快速进展的皮肤变化,导致面部失去弹性和皮肤硬化。所有病例的皮肤活检均显示组织病理学变化与已给出的诊断相符。这些儿童器官中最重要的变化是食管功能障碍和肺部纤维化。3例患者的X线检查显示存在肠道功能障碍。我们未发现肾脏、肝脏或神经系统疾病。(摘要截断于250字)