engleski

Comparison of Computerized Color Telethermography and Nailfold Capillaroscopy in Diagnostics of Secondary Raynaud’s Phenomenon in Children

Background: Raynaud’s phenomenon (RP) is a condition characterized by periodical vasospasm in response to cold temperatures or emotional stress exposure. To distinguish between primary and secondary RP, clinical examination, laboratory fi ndings, nailfold capillaroscopy (NC) and computerized color telethermography (CCTT) are necessary. Objectives: To analyze RP features in children in correlation with the most frequently associated laboratory tests, CCTT and NC. Methods: Th is study included children clinically recognized as RP in the period from 2011–2017 at the Referral Center for Pediatric and Adolescent Rheumatology Republic of Croatia. Laboratory data included serum level of IgG, C3, C4, CH50, RF, presence of ANA and ANCAs. Results: CCTT, performed in 188 patients, classifi cated 15 as primary RP, 57 as secondary RP, while in 47 no classifi cation could be made. Among patients classifi cated as secondary RP on CCTT, the most of them, 14 (24.6%), were diagnosed with juvenile idiopathic arthritis (JIA). Th ere were 5 patients (8.8%) with systemic sclerosis (SSc), 2 (3.5%) with mixed connective tissue disease (MCTD), 1 (1.7%) with systemic lupus erythematosus, 11 (19.3%) with undiff erentiated connective tissue disease (UCTD), whilst 24 (42.1%) had no evident other disease. Th e appearance of abnormal capillaroscopic pattern was found in 17 out of 89 patients and nonspecifi c capillaroscopic alterations were noticed in 27. Among patients with the appearance of abnormal capillaroscopic pattern, 5 (29.4%) were diagnosed with SSc, 3 (17.6%) with JIA, 2 (11.8%) with MCTD, 1 (5.9%) with dermatomyositis, 2 (11.8%) with UCTD, whilst 4 (23.5%) had no evident rheumatic disease. All patients with RP diagnosed with SSc and MCTD had both the appearance of abnormal capillaroscopic pattern and CCTT fi ndings consistent with secondary RP. No statistically signifi cant diff erence between NC and CCTT in predicting the diagnosis of secondary RP was determined (McNemar’s test, χ2 = 0.042, p = 0.838) nor was there signifi cant diff erence between NC and CCTT in regard to the results of laboratory fi ndings (χ2 = 1.042, p = 0.307). Conclusions: We found that nailfold capillaroscopy and CCTT were equally eff ective in the diagnosis of secondary RP in children. Th ere was no diff erence between them in regard to the results of immunological laboratory fi ndings distinctive with secondary RP.

Raynaud’s Phenomenon ; nailfold capillaroscopy ; Computerized Color Telethermography ; child

Sažetak objavljen u časopisu Reumatizam. 2018 ; 65:26, indeksiran u bazi podataka Embase (Scopus)