Children and adolescents
Pediatric systemic sclerosis
Raynaud's with skin thickening, digital ulcers or GI and lung involvement in a child.
What to look for
- Raynaud's, sclerodactyly, digital pitting or ulcers
- Dysphagia or reflux, dyspnea
- ANA with Scl-70 or anti-centromere
What to do
- Send ANA, ENA including Scl-70 and centromere, CBC, metabolic panel and urinalysis, and check BP.
- Get PFTs with DLCO, HRCT and an echocardiogram.
- Nailfold capillaroscopy if available.
About this urgency level
Early specialist assessment changes outcomes. Send the usual workup with the referral, but don't hold the referral while waiting for results.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.