González Pascual E, Esquinas Rychen G, Ruiz España A, Ros Viladoms J B, Juanola Roura X
Servicio de Pediatría, Unidad de Reumatología Pediátrica, Unidad Integrada Hospital Sant Joan de Déu-Hospital Clínic, Barcelona.
An Esp Pediatr. 1998 Jun;48(6):603-7.
The purpose of this study was to analyze the properties of Raynaud's phenomenon in childhood, as well as its evolution, pathology and differences with regard to adults.
The cases of patients affected by Raynaud's phenomenon between 1988 to 1996 in the pediatric rheumatology unit of Sant Joan de Déu in Barcelona have been reviewed. We evaluated the information regarding the clinical history and the complementary tests performed.
We examined the results of eight cases affected by Raynaud's phenomenon. All of these were girls with an average age of 9 years and 9 months. The most typical clinical feature was sensitivity to cold. From an analytical point of view, 62.5% of the cases had positive antinuclear antibodies. Nail-fold capillary microscopy, which was carried out in all patients, was abnormal in six cases and had a "scleroderma-like" pattern in three of them. According to Le Roy-Medsger diagnostic criteria, we found one case (12.5%) of Raynaud's phenomenon classified as primary, five more (62.5%) as probably secondary to a connective tissue disease and two cases as secondary (25%, a sclerodermic and connective tissue disease).
Raynaud's phenomenon could be the first symptom of a connective tissue disease, but in general there is a low prevalence in childhood. It is important to follow up these girls for a long period because of the high probability of developing a connective tissue disease. It is possible to do this thanks to anamnesy, clinical exploration, searching for antinuclear antibodies and nail-fold capillary microscopy.
本研究旨在分析儿童雷诺现象的特征、演变、病理以及与成人的差异。
回顾了1988年至1996年期间巴塞罗那圣琼·德乌儿科风湿病科收治的雷诺现象患者病例。我们评估了临床病史和所做的辅助检查信息。
我们检查了8例雷诺现象患者的结果。所有患者均为女孩,平均年龄9岁9个月。最典型的临床特征是对寒冷敏感。从分析角度看,62.5%的病例抗核抗体呈阳性。所有患者均进行了甲襞毛细血管显微镜检查,其中6例异常,3例呈“硬皮病样”模式。根据勒罗伊 - 梅兹格诊断标准,我们发现1例(12.5%)雷诺现象被归类为原发性,另外5例(62.5%)可能继发于结缔组织病,2例为继发性(25%,1例硬皮病和1例结缔组织病)。
雷诺现象可能是结缔组织病的首发症状,但总体而言在儿童中患病率较低。由于这些女孩患结缔组织病的可能性很高,因此长期随访很重要。借助病史采集、临床检查、检测抗核抗体和甲襞毛细血管显微镜检查可以做到这一点。