Raynaud's syndrome in children: systematic review and development of recommendations for assessment and monitoring
Language English Country Italy Media print-electronic
Document type Journal Article, Practice Guideline, Systematic Review
PubMed
27494080
PII: 10375
Knihovny.cz E-resources
- MeSH
- Antibodies, Antinuclear blood MeSH
- Biomarkers blood MeSH
- Child MeSH
- Consensus MeSH
- Humans MeSH
- Microscopic Angioscopy standards MeSH
- Adolescent MeSH
- Pediatrics standards MeSH
- Predictive Value of Tests MeSH
- Prognosis MeSH
- Disease Progression MeSH
- Raynaud Disease blood diagnosis therapy MeSH
- Rheumatology standards MeSH
- Risk Factors MeSH
- Serologic Tests standards MeSH
- Age Factors MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Practice Guideline MeSH
- Systematic Review MeSH
- Names of Substances
- Antibodies, Antinuclear MeSH
- Biomarkers MeSH
OBJECTIVES: To develop recommendations for investigation and monitoring of children with Raynaud's syndrome, based on paediatric evidence collated by a systematic review. METHODS: A systematic review was undertaken to establish the paediatric evidence for assessment and monitoring of Raynaud's syndrome. An expert panel including members of the Paediatric Rheumatology European Society (PRES) Scleroderma Working Group, were invited to a consensus meeting where recommendations were developed based on evidence graded by the systematic review and where evidence was lacking, consensus opinion. A nominal technique was used where 75% consensus was taken as agreement. RESULTS: The expert panel recommended testing anti-nuclear antibody (ANA), more specific antibodies associated with connective tissue disease and nail-fold capillaroscopy in all children presenting with Raynaud's syndrome as data suggests these can be risk factors for evolution into a connective tissue disease. The frequency of follow-up recommended depends on presence of these risk factors with the aim to detect evolving connective tissue disease early in high risk individuals. Those with no abnormalities on capillaroscopy and negative autoantibodies were deemed low risk of progression, whereas those with ANA positivity, specific autoantibodies and/or nailfold capillary changes were deemed high risk and more frequent follow-up was recommended. CONCLUSIONS: Recommendations, primarily based on consensus opinion, were agreed regarding investigation and monitoring of children who present with Raynaud's syndrome. Further prospective studies are needed to better define the risk factors for progression to connective tissue disease.
Alder Hey Children's NHS Foundation Trust Liverpool UK
Charles University Prague Czech Republic
Department of Paediatric Dermatology Cath Children's Hospital Wilhelmstift Hamburg Germany
Ghent University Hospital Belgium
Hamburger Zentrum für Kinder und Jugendrheumatologie Hamburg Germany
Istanbul Kanuni Sultan Süleyman Education and Research Hospital Turkey
Semmelweis University Budapest Hungary
Universidade Federal de São Paulo Brazil
Universitätsklinikum Hamburg Eppendorf Germany
University Children's Hospital Ljubljana Slovenia
