Role of thermography in paediatric Raynaud's phenomenon

  • Research type

    Research Study

  • Full title

    Role of distal dorsal difference and cold challenge performed by thermography in differentiation of Primary from Secondary Raynaud’s Phenomenon in children and young people up to the age of 18 years.

  • IRAS ID

    253674

  • Contact name

    Clare Pain

  • Contact email

    clare.pain@alderhey.nhs.uk

  • Sponsor organisation

    Clinical Research Business Unit, Alder Hey Children's NHS Foundation Trust

  • Duration of Study in the UK

    0 years, 6 months, 2 days

  • Research summary

    Raynaud's phenomenon causes discoloration, cold and numb/painful extremities in relation to cold or emotion.
    Children and young people with Raynaud's phenomenon may have primary Raynaud's which is a benign, non-tissue damaging disease or Raynaud's may be the first sign of a serious condition such as scleroderma or lupus.
    Evidence from adult studies have shown that risk factors for development of a connective tissue disease such as systemic scleroderma include scleroderma pattern nailfold capillary (NFC) changes (performed by looking at the small blood vessels in the nail cuticles with a microscope or magnifier) and positive specific autoantibodies (on a blood test). Patients with normal NFC patterns and negative autoantibodies are at very low risk of progression to disease and can be reassured.
    Adult studies have also shown that thermography (use of an infra-red camera) and cold challenge (putting hands in cool water and using infrared camera to assess how quickly the fingers rewarm) can differentiate primary from secondary Raynaud’s by both a distal dorsal difference (difference in temperature from the back of the hand to finger tips) of over one degree and rewarming curve parameters.
    There is a paucity of studies of Raynaud’s phenomenon in children and young people (CYP) with some evidence from studies involving small numbers of CYP that autoantibodies and nailfold capillaries can define the risk of progression to a connective tissue disorder.
    To our knowledge there are no current studies examining whether thermography and cold challenge can be a useful tool to differentiate primary from secondary Raynaud’s in this age group.
    At Alder Hey, we have undertaken thermography, cold challenge and nailfold capillaroscopy as part of routine care. We aim to review whether thermography and cold challenge can help differentiate between primary versus secondary Raynaud’s in CYP.

  • REC name

    North West - Liverpool Central Research Ethics Committee

  • REC reference

    18/NW/0815

  • Date of REC Opinion

    8 Jan 2019

  • REC opinion

    Favourable Opinion