OBJECTIVE: 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. PATIENTS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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.
OBJECTIVE: 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. PATIENTS AND METHODS: 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. RESULTS: 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). CONCLUSION: 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.