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Circulatory system in children with localized scleroderma
W Rokicki1, M Dukalska, J Rubisz-Brzezińska
1Department of Pediatric Cardiology, Silesian Medical School, 40-635 Katowice, ul. Ziolowa 46, Poland.
Insights
Children with localized scleroderma show circulatory system abnormalities, including ECG and echocardiographic findings, particularly affecting mitral valve function. Exercise tolerance remained comparable to controls, indicating specific cardiac impacts beyond physical growth differences.
Area of Science:
- Pediatrics
- Cardiology
- Rheumatology
Background:
- Localized scleroderma is an autoimmune condition affecting the skin.
- Potential systemic involvement, including the cardiovascular system, requires further investigation in pediatric cases.
Purpose of the Study:
- To comprehensively assess the circulatory system in children with localized scleroderma.
- To identify potential cardiac abnormalities and functional changes associated with the condition.
Main Methods:
- Pediatric and cardiologic examinations were performed on 43 children (ages 3-18).
- Included electrocardiogram (ECG), 24-h Holter monitoring, echocardiography with Doppler, and treadmill exercise testing.
- Exclusion of 3 children with congenital heart malformations.
Main Results:
- Children with scleroderma were lighter and shorter than controls.
- Common ECG abnormality: incomplete right bundle branch block; other ECG/Holter abnormalities noted.
- Abnormal echocardiograms in 16 children, primarily affecting mitral valve function and left ventricular indices.
Conclusions:
- Children with localized scleroderma exhibit distinct cardiovascular findings, notably mitral valve dysfunction.
- While physical growth may be affected, exercise capacity is not significantly different from controls.
- Cardiovascular monitoring is crucial for children diagnosed with localized scleroderma.
Abstract:
The circulatory system was studied in 43 children (ages 3-18 years, mean 10.6 years; 32 girls, 11 boys) suffering from localized cutaneous forms of scleroderma. The following studies were undertaken: general pediatric examination, cardiologic examination including routine electrocardiogram (ECG), 24-h Holter ECG monitoring, echocardiography plus Doppler study, and a treadmill exercise test. Three children found to have congenital heart malformations were excluded from the study. Children with localized scleroderma were often lighter and shorter than their appropriate controls. The most common ECG abnormality was incomplete right bundle branch block, but other ECG and Holter abnormalities were found as well. Abnormal echocardiographic results were obtained in 16 cases. The abnormalities concerned valvar function (in all heart valves but predominantly in the mitral valve). It was found that the children suffering from scleroderma had different indices than controls for left ventricular mass index, mitral valve function and left ventricular filling. During the exercise test (conducted according to Bruce's protocol) we found no difference between patients and controls.
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