Evaluation of Primary and Secondary Raynaud’s Phenomenon in Childhood

Öz

Objective: To evaluate the clinical, laboratory and capillaroscopic findings of pediatric patients with Raynaud’s phenomenon.

Material and Methods: Ninety-five pediatric patients who were diagnosed with Raynaud’s phenomenon between January 2014 and January 2021, were retrospectively examined. The demographic data, laboratory parameters and capillaroscopic findings of the patients were recorded. The capillaroscopic findings of the patients were classified as normal, nonspecific abnormalities and scleroderma pattern.

Results: Primary Raynaud’s phenomenon was present in 84 (88.5%) patients, and secondary Raynaud’s phenomenon was present in 11 (11.5%). Arthralgia, arthritis, rash and recurrent fever were significantly more common in secondary Raynaud’s phenomenon (p=0.001, p=<0.001, p=0.01, p=0.035, respectively). Antinuclear antibody positivity >1/320 was significantly higher in the patients with secondary Raynaud’s phenomenon (p=0.01). Of the 40 patients who had capillaroscopy performed, 2 had a scleroderma pattern, 19 had nonspecific changes, and 19 had normal nailfold capillaroscopic findings. Capillary irregularity, tortuous capillaries and increased branching were significantly higher in the secondary Raynaud’s phenomenon cases (p=0.015, p=0.015, p=0.003, respectively).

Conclusion: Having antinuclear antibody titer >1/320 and detection of capillary irregularity, tortuous capillaries and increased branching may be useful in distinguishing primary and secondary Raynaud’s phenomenon. 

Anahtar Kelimeler

• Antinuclear antibody
• capillaroscopy
• pediatric
• Raynaud’s Phenomenon
• rheumatology

Çocukluk Çağı Birincil ve İkincil Raynaud Fenomeni Olgularının Değerlendirilmesi

Öz

Amaç: Raynaud fenomeni ile takip edilen pediatrik hastaların klinik, laboratuvar ve kapilleroskopik bulgularını değerlendirmek.

Gereç ve Yöntemler: Ocak 2014 ile Ocak 2021 tarihleri arasında Raynaud fenomeni tanısı ile takip edilen 95 çocuk hasta geriye dönük olarak incelendi. Hastaların demografik verileri, laboratuvar parametreleri ve kapilleroskopik bulguları kaydedildi. Hastaların kapilleroskopik bulguları normal, nonspesifik anormallikler ve skleroderma paterni olarak sınıflandırıldı.

Bulgular: Birincil Raynaud fenomeni 84 hastada (%88.5), ikincil Raynaud fenomeni 11 hastada (%11.5) mevcuttu. Artralji, artrit, döküntü ve tekrarlayan ateş, sekonder Raynaud fenomeninde anlamlı olarak daha sıktı (sırasıyla p=0.001, p=<0.001, p=0.01, p=0.035). Sekonder Raynaud fenomeni olan hastalarda 1/320 titre ve üzerinde antinükleer antikor pozitifliği anlamlı olarak daha sıktı (p=0.01). Kapilleroskopi yapılan 40 hastanın 2’sinde skleroderma paterni, 19’unda nonspesifik değişiklik ve 19’unda normal kapilleroskopi bulguları vardı. İkincil Raynaud fenomeni olgularında kapiller düzensizlik, tortuyoz kapiller ve dallanma artışı anlamlı olarak daha sık saptandı (sırasıyla p=0.015, p=0.015, p=0.003).

Sonuç: Antinükleer antikor titresinin >1/320 olması ve kapiller düzensizlik, tortuyoz kapiller ve dallanma artışının saptanması, birincil ve ikincil Raynaud fenomenini ayırt etmede faydalı olabilir.

Anahtar Kelimeler

• Antinükleer antikor
• kapilleroskopi
• pediatri
• Raynaud Fenomeni
• Romatoloji

Kaynakça

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