Clinical and laboratory profile of juvenile-onset systemic sclerosis in a brazilian cohort

To characterize the clinical and laboratory profile of juvenile-onset compared to adult-onset systemic sclerosis in a large Brazilian cohort. Methods: Retrospective analysis of a cohort of 1016 systemic sclerosis patients followed at the Scleroderma Outpatient Clinic from two referral university centers in Brazil. Patients were classified as systemic sclerosis according to the 1980 American College of Rhaumatology (ACR) criteria. Juvenile-onset systemic sclerosis was defined if age at onset was Results: Thirty-one (3.1%) patients were classified as juvenile-onset systemic sclerosis. These patients were predominantly females (90.3%), Caucasians (71.0%), and presented diffuse systemic sclerosis (51.6%), with mean age at onset of 12.71 years. Compared to the adult-onset patients, juvenile onset was associated with diffuse systemic sclerosis (p < 0.001), calcinosis (p < 0.001), myositis (p = 0.050), and lower frequency of interstitial lung disease (p = 0.050), pulmonary hypertension (p = 0.035), and esophageal (p = 0.005) involvement. Conclusion: Juvenile-onset systemic sclerosis characterized a distinct clinical pattern in this large series of systemic sclerosis patients, since it was predominantly associated with diffuse systemic sclerosis without significant organ involvement41434

Espondiloptose em atleta

Os atletas adolescentes est&#227;o sob maior risco de lombalgia e les&#245;es estruturais da coluna. A espondil&#243;lise &#233; respons&#225;vel pela maioria das lombalgias em jovens esportistas e raramente ocorre em adultos. Relatamos o caso de uma paciente de 13 anos, atleta de jud&#244;, que chegou a nosso servi&#231;o com quadro de cinco meses de lombalgia progressiva durante os treinos, sendo inicialmente atribu&#237;da a causas mec&#226;nicas, sem que houvesse uma investiga&#231;&#227;o mais detalhada por m&#233;todos de imagem. Na admiss&#227;o j&#225; apresentava deformidade lombar, postura ant&#225;lgica e manobra de hiperextens&#227;o lombar em unipod&#225;lico positiva bilateralmente. Realizou-se investiga&#231;&#227;o, que evidenciou espondiloptose, sendo, ent&#227;o, submetida a tratamento cir&#250;rgico. Com base neste relato de caso, discutimos a abordagem diagn&#243;stica de lombalgia em atletas jovens, uma vez que a queixa de lombalgia cr&#244;nica pode ser marcador de uma les&#227;o estrutural, a qual pode ser definitiva e trazer perda funcional irrevers&#237;vel