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Wow 7 that is so young. I think that she has been exposed for too long and that's why she has lesions now. I didn't do a cold immersion test because of the awful appearance of toes, resting ppg's seemed very vasospastic.
Thanks,
Jodi



-----Original Message-----
From: Nicole Ball <[log in to unmask]>
To: [log in to unmask]
Sent: Thu, Jan 21, 2010 11:42 am
Subject: Re: 5 yrs old with Raynaud's


Raynauds can affect young children.  I myself was diagnosed with it at 7 yrs old and Dr. told me some simple things to do and that was the end of it.  If she has it, she has a severe case or has been exposed to cold too long.  Ulcers are very worrisome.  Frostbite certainly seems plausible also, had a gentleman who took an extensive walk with his dog in sneakers (up here in NH) in the snow and his feel got cold and wet, he ended up with frostbite and ulcers on all digits.  Was a cold emersion Raynauds test done?

Nicole

Nicole Ball, RVT
President for NNEVS
Frisbie Memorial Hospital
Vascular Lab
Rochester, NH




"Johnson, Bill" <[log in to unmask]>
Sent by: UVM Flownet <[log in to unmask]>
01/20/2010 03:30 PM
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Re: 5 yrs old with Raynaud's





Bill Johnson, Port Townsend, WA

It is my understanding that, while rare, Raynaud's can affect children.  In any case, an autoimmune process should be considered.  If anyone knows any rheumatologists, particularly a pediatric rheumatologist, I think that would be who to ask.  Have the color changes, red, white and blue been observed?  That might be significant.

________________________________

From: UVM Flownet on behalf of Jodi Zannino
Sent: Wed 1/20/2010 10:38 AM
To: [log in to unmask]
Subject: 5 yrs old with Raynaud's





Hello All,
I had an interesting case this am. A 5yr old girl , yes 5, with symptoms of discolored upper and sever lower extremity digits. Now has sores on the 3rd toe, bilaterally R>L.  She was recently treated for Lyme's.  The patient also lives in an old farm house- wood flooring and does not wear socks or slippers in house. This is the northeast and as you all know....it's been a cold winter so far!
The order was for Raynaud's of the lower extremity as they are the most symptomatic and she was referred by a podiatrist. The Brachial pulses were normal with normal pressures bilaterally(and ankles too).
Normal bilateral TBI's. PPG waveforms in the bilateral lower extremity digits were either normal or vasospasm in appearance (R>L) throughout.
I'm thinking this is some kind of autoimmune disease causing this. Have any of you seen a patient so young with this presentation? What are your thoughts?
I welcome your input?
Thanks,

JZ, RVT
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