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Dear Editor,
Congratulations Canadian Family Physician and Dr Ran D. Goldman for the "Child Health Update" on Raynaud's phenomenon (RP) [1]. I would like to point to a new study in childhood on this underrated functional vascular disease.
The pediatric research group of Gorski et al from Poland examined with the help of nail fold capillaroscopy and blood tests 66 patients with RG (34 undifferentiated RP and 32 secondary RP) aged 6-19 years and a control group with 20 healthy children [2]. Compared to the control group, significantly higher concentrations of endothelin-1 (p = 0.0134), sE-selectin and high-sensitivity C-reactive protein (hsCRP: p < 0.001) were found in the patients with RG, as well as a lower high-density lipoprotein cholesterol concentration in the lipid profile (p = 0.001). The group over 15 years also had higher levels of low-density lipoprotein fraction and triglyceride. As the analysis of multiple linear regression showed, among the capillaroscopic parameters, the more common occurrence of giant capillaries / microhemorrhages (p = 0.03) and reduced number of capillaries (<6/mm; p = 0.08) most strongly determined the values of sE-selectin and hsCRP [2].
Accordingly, the current guideline of the European Society for Vascular Medicine recommends for the diagnosis in all cases presenting with RP blood tests including full blood count, erythrocyte sedimentation rate or CRP, and antinuclear antibody testing, and capil...
Show MoreCompeting Interests: None declared.