Interconsultas em reumatologia pediátrica: casuística de hospital terciário no Sul do Brasil

Ricardo Ribeiro, M. Bandeira
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Abstract

OBJECTIVE: To describe the clinico-epidemiological profile of pediatric patients seen via inter-consultation in a pediatric rheumatology (PR) outpatient clinic. METHODS: Cross-sectional and observational study that analyzed the medical records of patients seen in the form of inter-consultations in a PR outpatient clinic of a tertiary hospital for 14 months. Epidemiological, clinical history and laboratory tests data were collected and descriptive statistics were performed. RESULTS: 37 patients were included, 27 (73%) female and 10 (27%) male, with a median age of 12.4 years (min.: 1.3/max.: 15.9). Having performed several complementary exams, patients were referred by 13 different specialties, with a predominance of pediatric dermatology. In the first consultation with a pediatric rheumatologist, the main complaints were arthralgia (51.3%), skin blemishes (32.4%) and skin rash (29.7%). The period between the onset of symptoms and the consultation ranged between 16 and 4554 days, with a median of 730 days. Twenty (54.1%) patients had the exclusion of a rheumatological disease, three (8.1%) lost follow-up and 14 (37.8%) were diagnosed with rheumatological diseases, the most common being linear scleroderma (28.6%), juvenile systemic lupus erythematosus (28.6%), juvenile idiopathic arthritis (14.3%), and juvenile dermatomyositis (14.3%). CONCLUSION: The main complaints of patients referred to RP were arthralgia and skin lesions, with a long period of symptom evolution, in addition to a wide age range and the predominant role of female patients. In addition, it is noted that previously the evaluation of the pediatric rheumatologist, patients consulted several specialties and were exposed to several complementary exams.
儿科风湿病会诊:巴西南部一家三级医院的诡辩
目的:描述通过儿科风湿病(PR)门诊会诊的儿科患者的临床流行病学特征。方法:采用横断面和观察性研究,对某三级医院PR门诊14个月间以会诊形式就诊的患者病历进行分析。收集流行病学、临床病史和实验室检测资料,并进行描述性统计。结果:纳入37例患者,女性27例(73%),男性10例(27%),中位年龄12.4岁(最小:1.3/最大)。: 15.9)。在进行了几次补充检查后,患者被13个不同的专科转诊,以儿科皮肤科为主。首次咨询儿科风湿病专家时,主要主诉为关节痛(51.3%)、皮肤瑕疵(32.4%)和皮疹(29.7%)。症状出现和咨询之间的时间为16至4554天,中位数为730天。20例(54.1%)患者排除了风湿病,3例(8.1%)患者失去了随访,14例(37.8%)患者被诊断为风湿病,最常见的是线状硬皮病(28.6%)、幼年系统性红斑狼疮(28.6%)、幼年特发性关节炎(14.3%)和幼年皮肌炎(14.3%)。结论:RP患者的主诉以关节痛和皮肤病变为主,症状演变周期长,且年龄范围广,以女性患者为主。此外,值得注意的是,以前儿科风湿病专家的评估,患者咨询了几个专业,并暴露于几个补充检查。
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