medigraphic.com
SPANISH

Acta Pediátrica de México

Órgano Oficial del Instituto Nacional de Pediatría
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2014, Number 1

<< Back Next >>

Acta Pediatr Mex 2014; 35 (1)

Evaluation of dystrophic calcinosis in juvenile dermatomyositis and systemic sclerosis

Sáez-de Ocariz M, Carrillo- Rincón A, Murata C, Gutiérrez- Hernández A, Palma-Rosillo RM, Altamirano-Bustamante N
Full text How to cite this article

Language: Spanish
References: 18
Page: 7-14
PDF size: 317.44 Kb.


Key words:

dystrophic calcinosis, juvenile dermatomyositis, systemic sclerosis, scintigraphy.

Text Extraction

Background: Dystrophic calcinosis is associated with juvenile dermatomyositis and systemic sclerosis. Clinical diagnosis is performed through the detection of subcutaneous, hard nodules. Conventional radiographic studies may demonstrate calcium deposits, however, with very early lesions X-rays may prove insufficient. There are a few studies where scintilliography has been used to identify dystrophic calcinosis.
Objectives: To estimate the frequency of dystrophic calcinosis in patients with juvenile dermatomyositis and systemic sclerosis/CREST syndrome. To estimate the concordance between the diagnoses of dystrophic calcinosis obtained by physical examination and scintigraphy.
Patients and Methods: Observational, transversal and comparative study in which patients of both genders, between 5 and 7 years of age with the diagnoses of juvenile dermatomyositis and systemic sclerosis/CREST syndrome were included in order to detect dystrophic calcinosis by physical examination and scintigraphy. Fisher’s exact test was used to evaluate the association between both diagnostic methods, Kappa test was used to evaluate the level of concordance between both methods and a distribution by group analysis was used to analyze the extent of dystrophic calcinosis with both methods. Sensitivity and specificity for scintigraphic findings in soft tissues, bony protrusions , ribs and vertebrae was also estimated.
Results: The frequency of dystrophic calcinosis was 80%. Dystrophic calcinosis was detected through physical examination in 16 patients and through scintigraphy in 9 patients. No association or concordance was found between the clinical and the scintigraphic findings. Scintigraphy has a 37.5% sensitivity for the detection of dystrophic calcinosis in soft tissues and 43.8% in bony protrusions, but is ideal for its detection in the ribs.
Conclusions: Both, physicial examination and scintigraphy are complementary tools for the detection of dystrophic calcinosis.


REFERENCES

  1. Gutierrez A Jr, Wetter DA. Calcinosis cutis in autoimmune connective tissue diseases. Dermatol Ther 2012;25:195- 206.

  2. Walsh JS, Fairley JA. Calcifying disorders of the skin. J Am Acad Dermatol 1995;33:693-706.

  3. Boulman N, Slobodin G, Rozenbaum M, Rosner I. Calcinosis in rheumatic diseases. Semin Arthritis Rheum 2005;34:805-12.

  4. Reiter N, El-Shabrawi L, Leinweber B, Berghold A, Aberer E. Calcinosis cutis: part I. Diagnostic pathway. J Am Acad Dermatol 2011;65:1-12.

  5. Agarwal V, Sachdev A, Dabra AK. Calcinosis in juvenile dermatomyositis. Radiology 2007;242:307-11.

  6. Robertson LP, Marshall RW, Hickling P. Treatment of cutaneous calcinosis in limited systemic sclerosis with minocycline. Ann Rheum Dis 2003;62:267-69.

  7. Chauhan NS, Sharma YP. A child with skin nodules and extensive soft tissue calcification. Br J Radiol 2012;85:193-95.

  8. Nunley JR, Jones LME. Calcinosis cutis. E Medicine Specialties 2009:1-18. http://www.emedicine.com/derm/ topic66.html

  9. Bowyer SL, Blane CE, Sullivan DB, Cassidy JT. Childhood dermatomyositis: factors predicting functional outcome and development of dystrophic calcification. J Pediatr 1983;103:882-88.

  10. Pachman LM, Abbott K, Sinacore JM, et al. Duration of illness is an important variable for untreated children with juvenile dermatomyositis. J Pediatr 2006;148:247-53.

  11. Blane CE, White SJ, Braunstein EM, Bowyer SL, Sullivan DB. Patterns of calcification in childhood dermatomyositis. Am J Roentgenol 1984;142:397-400. Acta Pediátrica de México 14 Volumen 35, Núm. 1, enero-febrero, 2014

  12. Fishel B, Diamant S, Papo I, Yaron M. CT assessment of calcinosis in a patient with dermatomyositis. Clin Rheumatol 1986;5:242–4.

  13. Cairoli E, Garra V, Bruzzone MJ, Gambini JP. Extensive calcinosis in juvenile dermatomyositis. Acta Reumatol Port 2011;36:180-81

  14. Palossari K, Vuotila J, Takalo R, et al. Contrast-enhanced dynamic and static MRI correlates with quantitative 99cT labeled nanocolloid scintigraphy. Study of early rheumatoid arthritis patients. Rheumatol 2004;43:1364-73.

  15. Wu Y, Seto H, Shimizu M. Extensive soft-tissue involvement of dermatomyositis detected by whole-body scintigraphy with 99mTC-MDP and 201Tl-chloride. Ann Nucl Med 1006;10:127-30.

  16. Bar- Server Z, Mukamel M, Harel L, Hardoff R. Scintigraphic evaluation of calcinosis in juvenile dermatomyositis with Tc-99m MDP. Clin Nucl Med 2000;25:1013-16.

  17. Colamussi P, Prandin N, Cittanti C, Feggil L, Giganti M. Scintigraphy in rheumatic diseases. Best Pract Res Clin Rheumatol 2004;18:909-26.

  18. Peller P, Ho V, Kransdorf MJ. Extraosseus Tc99 MDP uptake: a pathophysiological approach. Radiographic 1993;13:715-34.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Acta Pediatr Mex. 2014;35