Raynaud phenomenon in children

[摘要] Question I have several patients, mostly girls, who are living with Raynaud phenomenon. Does this condition appear in children, and what should be the course of action? Answer Raynaud phenomenon, described in the 1860s, can present in children and even in the first decade of life. While most children will have primary Raynaud phenomenon, with no serious adverse consequences, in others it might be a sign of a pending systemic disease. Those children with a positive reaction to antinuclear antibody, specific autoantibodies associated with connective tissue disease, or nail fold capillary changes require referral to a pediatric rheumatologist and close follow-up. As a medical student in Paris, Maurice Raynaud described “local asphyxia and symmetrical gangrene of the extremities” as part of his doctoral thesis: 20 women and 5 men had a series of colour changes in their hands and feet when exposed to the cold or when the patients were under stress. ¹ Despite being the one to describe what is known today as Raynaud phenomenon (RP), Raynaud was never able to obtain a position as a physician owing to the political scene in Paris during the 1860s. ² Raynaud phenomenon is recognized today as a transient vasospasm of peripheral arteries and arterioles that classically results in triphasic colour changes in the affected region, and it is associated with a variety of medical conditions. ³ The vasospasm causes pallor (white), followed by dilation of the capillaries and venous stasis resulting in cyanosis (blue), and finally the arteries and arterioles dilate, causing rapid return of blood flow and reactive hyperemia (red) ⁴ ( Figure 1 ). The fingers are the most commonly affected region, usually as a response to stressors such as cold exposure.

[学科分类] 卫生学