Prospective Nailfold Capillaroscopy evaluation of Raynaud's phenomenon in children and adolescents

Prospective Nailfold Capillaroscopy evaluation of Raynaud's phenomenon in children and adolescents

Author Piotto, Daniela Gerent Petry Autor UNIFESP Google Scholar
Hilário, Maria Odete Esteves Autor UNIFESP Google Scholar
Carvalho, Natalia da Silva Autor UNIFESP Google Scholar
Len, Claudio Arnaldo Autor UNIFESP Google Scholar
Andrade, Luiz Eduardo Coelho Autor UNIFESP Google Scholar
Terreri, Maria Teresa Ramos Ascensão Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: To evaluate prospectively the clinical features and nailfold capillaroscopy findings of a cohort of children and adolescents who presented Raynaud's phenomenon (RP) without criteria for autoimmune rheumatic diseases.Methods: 40 children and adolescents with isolated RP were included. Evidence of systemic autoimmune rheumatic diseases (SARD) was ruled out by thorough clinical and laboratory examination. Concomitantly we also performed wide-field nailfold capillaroscopy evaluation using an optical microscope with magnifications of 10 and 16X. All patients were prospectively re-evaluated within a mean interval time between evaluations of 1.6 years.Results: Thirty (75%) out of 40 patients were female with a mean age of 14.6 years and mean follow-up time of 4.2 years. The mean age of disease onset was 10.4 years and the mean time until diagnosis was 1.4 years. Fourteen out of 40 patients (35%) presented antinuclear antibodies (ANA). Five (12.5%) patients had altered nailfold capillaroscopy at first examination: four presented non-specific microangiopathy and one presented scleroderma pattern. At the re-evaluation three patients (7.5%) presented nailfold capillaroscopy alterations (two scleroderma pattern and one non-specific microangiopathy). The two patients who showed scleroderma pattern at the nailfold capillaroscopy presented along the follow-up a diagnosis of mixed connective tissue disease and hypothyroidism, respectively. A girl with normal nailfold capillaroscopy and presence of autoantibodies was diagnosed with systemic lupus erythematosus after 1 year of initial evaluation. None of the other children presented diagnosis of SARD along the follow-up.Conclusions: Primary Raynaud s phenomenon remained the diagnosis in most cases in this series of children and adolescents presenting with initial RP complaint. Nailfold capillaroscopy and determination of autoantibodies were useful ancillary tools in the investigation of possible evolution towards SARD.
Keywords Capillaroscopy
Adolescent
Child
Raynaud's phenomenon
Autoimmune rheumatic diseases
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 07/55617-1
Date 2013-04-01
Published in Acta Reumatologica Portuguesa. Alges: Publisaude-edicoes Medicas Lda, v. 38, n. 2, p. 114-121, 2013.
ISSN 0303-464X (Sherpa/Romeo, impact factor)
Publisher Publisaude-edicoes Medicas Lda
Extent 114-121
Origin http://www.actareumatologica.pt/article_download.php?id=899
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000322099300006
URI http://repositorio.unifesp.br/11600/42093

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