Issue 2/2026
Vasilev, T.
Clinic of Rheumatology, Children’s Hospital “Ivan Mitev” – Sofia,
Department of Pediatrics, Medical University – Sofia
Raynaud’s phenomenon in children and adolescents is a clinical syndrome characterized by recurrent episodes of transient vasospasm of small arteries and arterioles, most commonly affecting the acral regions of the extremities. In pediatric patients, the condition has particular clinical significance, as it is frequently primary and functional with a favorable prognosis, but in a subset of cases it represents an early manifestation of an underlying systemic connective tissue disease. This dual nature necessitates a structured diagnostic approach and long-term follow-up. This narrative review summarizes current evidence on the epidemiology, pathogenesis, and pathophysiology of Raynaud’s phenomenon in children and adolescents, with a focus on clinical presentation, differential diagnosis, and diagnostic algorithms. The role of nailfold capillaroscopy and autoantibody testing in distinguishing primary from secondary Raynaud’s phenomenon and in identifying patients at increased risk of disease progression is highlighted. Special attention is given to the therapeutic approach in pediatric patients, where non-pharmacological measures and patient and family education constitute the cornerstone of management, while pharmacological therapy is reserved for selected cases and tailored to disease severity and underlying conditions. In conclusion, careful monitoring and early recognition of secondary forms are essential to improve long-term outcomes in children and adolescents with Raynaud’s phenomenon.
Key words: Raynaud’s phenomenon; children and adolescents; nailfold capillaroscopy; connective tissue diseases; differential diagnosis
Address for correspondence:
Teodor Vasilev, MD, PhD
Clinic of Rheumatology, Children’s
Hospital “Ivan Mitev” – Sofia
11, Аcad. Ivan Geshov, Blvd.
1612, Sofia
e-mail: tvasilev@medfac.mu-sofia.bg