Division of Angiology, Department of Medicine II, Medical University of Vienna, Austria, Medical University of Vienna, Vienna, Austria.
Department of Pediatrics, University Children's Hospital, Wien, Austria.
RMD Open. 2023 Mar;9(1). doi: 10.1136/rmdopen-2023-003077.
To characterise associations between individual nailfold capillary aberrations with autoantibodies in a cross-sectional study on children and adults with Raynaud's phenomenon (RP).
Consecutive children and adults with RP and without previously known connective tissue disease (CTD) systemically underwent nailfold capillaroscopy and laboratory tests for the presence of antinuclear antibodies (ANA). The prevalence of individual nailfold capillary aberrations and ANA was assessed, and the associations between individual nailfold capillary aberrations and ANA were analysed separately in children and adolescents.
In total, 113 children (median age 15 years) and 2858 adults (median age 48 years) with RP and without previously known CTD were assessed. At least one nailfold capillary aberration was detected in 72 (64%) of included children and in 2154 (75%) of included adults with RP (children vs adults p<0.05). An ANA titre ≥1:80, ≥1:160 or≥1:320 was observed in 29%, 21% or 16% of included children, and in 37%, 27% or 24% of screened adults, respectively. While the occurrence of individual nailfold capillary aberrations was related to the presence of an ANA titre of ≥1:80 in adults (reduced capillary density, avascular fields, haemorrhages, oedema, ramifications, dilations and giant capillaries: each p<0.001), no comparable association between nailfold capillary aberrations and ANA was observed in children with RP without previously known CTD.
In contrast to adults, the association between nailfold capillary aberrations and ANA might be less pronounced in children. Further studies are warranted to validate these observations in children with RP.
在一项关于雷诺现象（RP）患儿和成人的横断面研究中，描述甲襞毛细血管异常与自身抗体之间的关联。
连续纳入有 RP 且无先前已知结缔组织病（CTD）的患儿和成人，系统性地进行甲襞毛细血管显微镜检查和抗核抗体（ANA）检测。评估了个体甲襞毛细血管异常和 ANA 的患病率，并分别在儿童和青少年中分析了个体甲襞毛细血管异常与 ANA 之间的关联。
共评估了 113 例（中位年龄 15 岁）有 RP 且无先前已知 CTD 的儿童和 2858 例（中位年龄 48 岁）成人。在纳入的 RP 患儿中，至少有一个甲襞毛细血管异常的比例为 72%（64%），在纳入的 RP 成人中为 2154 例（75%）（儿童 vs 成人，p<0.05）。在纳入的儿童中，ANA 滴度≥1:80、≥1:160 或≥1:320 的比例分别为 29%、21%或 16%，在筛查的成人中，相应的比例分别为 37%、27%或 24%。虽然个体甲襞毛细血管异常的发生与成人中 ANA 滴度≥1:80 有关（毛细血管密度降低、无血管区、出血、水肿、分支、扩张和巨大毛细血管：均 p<0.001），但在无先前已知 CTD 的 RP 患儿中，并未观察到甲襞毛细血管异常与 ANA 之间存在类似的关联。
与成人相比，在无先前已知 CTD 的 RP 患儿中，甲襞毛细血管异常与 ANA 之间的关联可能不太明显。需要进一步的研究来验证这些在 RP 患儿中的观察结果。
