Skip to main content
Erschienen in: Rheumatology International 2/2020

26.08.2019 | Observational Research

Nailfold capillaroscopy and autoimmune connective tissue diseases in patients from a Portuguese nailfold capillaroscopy clinic

verfasst von: Vera Bernardino, Ana Rodrigues, Ana Lladó, António Panarra

Erschienen in: Rheumatology International | Ausgabe 2/2020

Einloggen, um Zugang zu erhalten

Abstract

Raynaud’s phenomenon (RP) is frequent in autoimmune connective tissue diseases (AICTD) and its approach includes nailfold capillaroscopy (NFC), as it is a non-invasive technique that permits direct visualization of the microcirculation. The aim of this study is to analyze and establish clinical correlations between NFC findings and particular aspects of autoimmune disorders. This is a retrospective study. Clinical data from patients attending our NFC clinic were reviewed. Inclusion criteria included AICTD previous diagnosis, which included systemic sclerosis (SSc), mixed connective tissue disease (MCTD), systemic lupus erythematosus (SLE), Sjögren syndrome, inflammatory idiopathic myopathies (IIM), rheumatoid arthritis, undifferentiated connective tissue disease and antiphospholipid syndrome (APS). Videocap® version 3.0 biomicroscope was used. NFC score was determined. For statistics, SPSS software was utilized. 384 patients were included; most of them were women, with mean age of 47 years. RP was present in 91% of the patients, with greater prevalence in SSc and MCTD. Scleroderma pattern was the most prevalent NFC pattern, mainly in SSc, MCTD and IIM. Mean capillary density was reduced in IIM, SSc and MCTD. NFC score was worse in SSc, IIM and MCTD. In patients with AICTD, RP is related to microvascular damage and worse NFC score. NFC scleroderma pattern correlates with SSc classification criteria score. In MCTD, scleroderma pattern relates to myositis. SLE and APS reveal significant hemorrhages, but not related to APS antibodies. This study highlights the possible role of NFC as biomarker of AICTD, particularly in SSc and IIM.
Literatur
1.
Zurück zum Zitat Silman A, Holligan S, Brennan P et al (1990) Prevalence of symptoms of Raynaud’s phenomenon in general practice. BMJ 301(6752):590e2 Silman A, Holligan S, Brennan P et al (1990) Prevalence of symptoms of Raynaud’s phenomenon in general practice. BMJ 301(6752):590e2
2.
Zurück zum Zitat Smith V, Thevissen K, Trombetta AC et al (2016) Nailfold capillaroscopy and clinical applications in systemic sclerosis. Microcirculation 23:364–372PubMed Smith V, Thevissen K, Trombetta AC et al (2016) Nailfold capillaroscopy and clinical applications in systemic sclerosis. Microcirculation 23:364–372PubMed
3.
Zurück zum Zitat Cutolo M, Sulli A, Pizzorni C et al (2000) Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 27:155–160PubMed Cutolo M, Sulli A, Pizzorni C et al (2000) Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 27:155–160PubMed
4.
Zurück zum Zitat Cutolo M, Sulli A, Smith V (2013) How to perform and interpret capillaroscopy. Best Pract Clin Rheumatol 27:237–248 Cutolo M, Sulli A, Smith V (2013) How to perform and interpret capillaroscopy. Best Pract Clin Rheumatol 27:237–248
5.
Zurück zum Zitat Cutolo M, Melsens K, Wijnant S et al (2018) Nailfold capillaroscopy in systemic lupus erythematosus: a systematic review and critical appraisal. Autoimmun Rev 17:844–852 Cutolo M, Melsens K, Wijnant S et al (2018) Nailfold capillaroscopy in systemic lupus erythematosus: a systematic review and critical appraisal. Autoimmun Rev 17:844–852
6.
Zurück zum Zitat Sebastiani M, Manfredi A, Vukatana G et al (2012) Predictive role of capillaroscopic skin ulcer risk index in systemic sclerosis: a multicenter validation study. Ann Rheum Dis 71(1):67–70PubMed Sebastiani M, Manfredi A, Vukatana G et al (2012) Predictive role of capillaroscopic skin ulcer risk index in systemic sclerosis: a multicenter validation study. Ann Rheum Dis 71(1):67–70PubMed
7.
Zurück zum Zitat van den Hoogen F, Khanna D, Fransen J et al (2013) 2013 classification criteria for systemic sclerosis: an American college of rheumatology/european league against rheumatism collaborative iniciative. Ann Rheum 72:1747–1755 van den Hoogen F, Khanna D, Fransen J et al (2013) 2013 classification criteria for systemic sclerosis: an American college of rheumatology/european league against rheumatism collaborative iniciative. Ann Rheum 72:1747–1755
8.
Zurück zum Zitat Hochberg MC (1997) Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40(9):1725PubMed Hochberg MC (1997) Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40(9):1725PubMed
9.
Zurück zum Zitat Alarcon-Segovia D, Villareal M (1987) Classification and diagnostic criteria for mixed connective tissue disease. In: Kasukawa R, Sharp GC (eds) Mixed connective tissue disease and anti-nuclear antibodies. Excerpta Medica, Amsterdam, pp 33–40 Alarcon-Segovia D, Villareal M (1987) Classification and diagnostic criteria for mixed connective tissue disease. In: Kasukawa R, Sharp GC (eds) Mixed connective tissue disease and anti-nuclear antibodies. Excerpta Medica, Amsterdam, pp 33–40
10.
Zurück zum Zitat Amigues JM, Cantagrel A, Abbal M et al (1996) Comparative study of 4 diagnosis criteria sets for mixed connective tissue disease in patients with anti-RNP antibodies. Autoimmunity Group of the Hospitals of Toulouse. J Rheumatol 23(12):2055–2062PubMed Amigues JM, Cantagrel A, Abbal M et al (1996) Comparative study of 4 diagnosis criteria sets for mixed connective tissue disease in patients with anti-RNP antibodies. Autoimmunity Group of the Hospitals of Toulouse. J Rheumatol 23(12):2055–2062PubMed
11.
Zurück zum Zitat Aletaha D, Neogi T, Silman AJ et al (2010) Rheumatoid arthritis classification criteria: an American college of rheumatology/european league against rheumatism collaborative initiative. Ann Rheum Dis 69:1580–1588PubMed Aletaha D, Neogi T, Silman AJ et al (2010) Rheumatoid arthritis classification criteria: an American college of rheumatology/european league against rheumatism collaborative initiative. Ann Rheum Dis 69:1580–1588PubMed
12.
Zurück zum Zitat Shiboski CH, Shiboski SC, Seror R et al (2017) 2016 American college of rheumatology/european league against rheumatism classification criteria for primary sjögren’s syndrome: a consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis 76(1):9–16PubMed Shiboski CH, Shiboski SC, Seror R et al (2017) 2016 American college of rheumatology/european league against rheumatism classification criteria for primary sjögren’s syndrome: a consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis 76(1):9–16PubMed
13.
Zurück zum Zitat Miyakis S, Lockshin MD, Atsumi T et al (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 4:295–306PubMed Miyakis S, Lockshin MD, Atsumi T et al (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 4:295–306PubMed
14.
Zurück zum Zitat Mosca M, Neri R, Bombardieri S (1999) Undifferentiated connective tissue diseases (UCTD): a review of the literature and a proposal for preliminary classification criteria. Clin Exp Rheumatol 17:615–620PubMed Mosca M, Neri R, Bombardieri S (1999) Undifferentiated connective tissue diseases (UCTD): a review of the literature and a proposal for preliminary classification criteria. Clin Exp Rheumatol 17:615–620PubMed
15.
Zurück zum Zitat Lundberg I, Tjärnlund A, Bottai M et al (2017) 2017 European league against rheumatism/American college of rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Arthritis Rheumatol 69(12):2271–2282PubMedPubMedCentral Lundberg I, Tjärnlund A, Bottai M et al (2017) 2017 European league against rheumatism/American college of rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Arthritis Rheumatol 69(12):2271–2282PubMedPubMedCentral
17.
Zurück zum Zitat Cutolo M, Pizzorni C, Tuccio M et al (2004) Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis. Rheumatology 43:719–726PubMed Cutolo M, Pizzorni C, Tuccio M et al (2004) Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis. Rheumatology 43:719–726PubMed
18.
Zurück zum Zitat Kabasakal Y, Elvins D, Ring E et al (1996) Quantitative nailfold capillaroscopy findings in a population with connective tissue disease and in normal healthy controls. Ann Rheum Dis 55:507–512PubMedPubMedCentral Kabasakal Y, Elvins D, Ring E et al (1996) Quantitative nailfold capillaroscopy findings in a population with connective tissue disease and in normal healthy controls. Ann Rheum Dis 55:507–512PubMedPubMedCentral
19.
Zurück zum Zitat Belch J, Carlizza A, Carpentier PH et al (2017) ESVM guidelines—the diagnosis and management of Raynaud’s phenomenon. VASA 46(6):413–423PubMed Belch J, Carlizza A, Carpentier PH et al (2017) ESVM guidelines—the diagnosis and management of Raynaud’s phenomenon. VASA 46(6):413–423PubMed
20.
Zurück zum Zitat Meier FM, Frommer KW, Dinser R et al (2012) Update on the profile of the EUSTAR cohort: an analysis of the EULAR Scleroderma Trials and Research group database. Ann Rheum Dis 71(8):1355–1360PubMed Meier FM, Frommer KW, Dinser R et al (2012) Update on the profile of the EUSTAR cohort: an analysis of the EULAR Scleroderma Trials and Research group database. Ann Rheum Dis 71(8):1355–1360PubMed
21.
Zurück zum Zitat Tani C, Carli L, Vagnani S et al (2014) The diagnosis and classification of mixed connective tissue disease. J Autoimmun 48–49:46–49PubMed Tani C, Carli L, Vagnani S et al (2014) The diagnosis and classification of mixed connective tissue disease. J Autoimmun 48–49:46–49PubMed
22.
Zurück zum Zitat Sharp GC (1987) Diagnostic criteria for classification of MCTD. In: Kasukawa R, Sharp GC (eds) Mixed connective tissue diseases and anti-nuclear antibodies. Elsevier, Amsterdam, pp 23–32 Sharp GC (1987) Diagnostic criteria for classification of MCTD. In: Kasukawa R, Sharp GC (eds) Mixed connective tissue diseases and anti-nuclear antibodies. Elsevier, Amsterdam, pp 23–32
23.
Zurück zum Zitat Kasukawa R et al (1987) Preliminary diagnostic criteria for classification of mixed connective tissue disease. In: Kasukawa R, Sharp GC (eds) Mixed connective tissue diseases and anti-nuclear antibodies. Elsevier, Amsterdam, pp 41–47 Kasukawa R et al (1987) Preliminary diagnostic criteria for classification of mixed connective tissue disease. In: Kasukawa R, Sharp GC (eds) Mixed connective tissue diseases and anti-nuclear antibodies. Elsevier, Amsterdam, pp 41–47
24.
Zurück zum Zitat Alarcon-Segovia D, Cardiel MH (1987) Classification and diagnostic criteria for mixed connective tissue disease. In: Kasukawa R, Sharps GC (eds) Mixed connective tissue diseases and anti-nuclear antibodies. Elsevier, Amsterdam, pp 33–40 Alarcon-Segovia D, Cardiel MH (1987) Classification and diagnostic criteria for mixed connective tissue disease. In: Kasukawa R, Sharps GC (eds) Mixed connective tissue diseases and anti-nuclear antibodies. Elsevier, Amsterdam, pp 33–40
25.
Zurück zum Zitat de Holanda MD, Bonfá E, Fuller R et al (2007) Capillaroscopy is a dynamic process in mixed connective tissue disease. Lupus 16(4):254–258 de Holanda MD, Bonfá E, Fuller R et al (2007) Capillaroscopy is a dynamic process in mixed connective tissue disease. Lupus 16(4):254–258
26.
Zurück zum Zitat Hoffman IE, Peene I, Meheus L et al (2004) Specific antinuclear antibodies are associated with clinical features in systemic lupus erythematosus. Ann Rheum Dis 53(9):1155–1158 Hoffman IE, Peene I, Meheus L et al (2004) Specific antinuclear antibodies are associated with clinical features in systemic lupus erythematosus. Ann Rheum Dis 53(9):1155–1158
27.
Zurück zum Zitat Pavlov-Dolijanovic S, Damjanov NS, Vujasinovic SNZ et al (2013) Is there a difference in systemic lupus erythematosus with and without Raynaud’s phenomenon? Rheumatol Int 33(4):859–865PubMed Pavlov-Dolijanovic S, Damjanov NS, Vujasinovic SNZ et al (2013) Is there a difference in systemic lupus erythematosus with and without Raynaud’s phenomenon? Rheumatol Int 33(4):859–865PubMed
28.
Zurück zum Zitat Vayssairat M, Abuaf N, Baudot N et al (1998) Abnormal IgG cardiolipin antibody titers in patients with Raynaud’s phenomenon and/or related disorders: prevalence and clinical significance. J Am Acad Dermatol 38(4):555–558PubMed Vayssairat M, Abuaf N, Baudot N et al (1998) Abnormal IgG cardiolipin antibody titers in patients with Raynaud’s phenomenon and/or related disorders: prevalence and clinical significance. J Am Acad Dermatol 38(4):555–558PubMed
29.
Zurück zum Zitat Youinou P, Pennec YL, Katsikis P et al (1990) Raynaud’s phenomenon in primary Sjögren’s syndrome. Br J Rheumatol 29(3):205–207PubMed Youinou P, Pennec YL, Katsikis P et al (1990) Raynaud’s phenomenon in primary Sjögren’s syndrome. Br J Rheumatol 29(3):205–207PubMed
30.
Zurück zum Zitat Kraus A, Caballero-Uribe C, Jakez J et al (1992) Raynaud’s Phenomenon in primary Sjögren’s syndrome. Association with other extraglandular manifestations. J Rheumatol 19(10):1572–1574PubMed Kraus A, Caballero-Uribe C, Jakez J et al (1992) Raynaud’s Phenomenon in primary Sjögren’s syndrome. Association with other extraglandular manifestations. J Rheumatol 19(10):1572–1574PubMed
31.
Zurück zum Zitat Tektonidou M, Kaskani E, Skoupoli FN et al (1999) Microvascular abnormalities in Sjögren’s syndrome: nailfold capillaroscopy. Rheumatology 38:826–830PubMed Tektonidou M, Kaskani E, Skoupoli FN et al (1999) Microvascular abnormalities in Sjögren’s syndrome: nailfold capillaroscopy. Rheumatology 38:826–830PubMed
33.
Zurück zum Zitat Dobloug C, Garen T, Bitter H et al (2015) Prevalence and clinical characteristics of adult polymyositis and dermatomyositis; data from a large and unselected Norwegian cohort. Ann Rheum Dis 74(8):1551–1556PubMed Dobloug C, Garen T, Bitter H et al (2015) Prevalence and clinical characteristics of adult polymyositis and dermatomyositis; data from a large and unselected Norwegian cohort. Ann Rheum Dis 74(8):1551–1556PubMed
34.
Zurück zum Zitat Katzap E, Barilla-LaBarca ML, Marder G (2011) Antisynthetase syndrome. Curr Rheumatol Rep 13(3):175–181PubMed Katzap E, Barilla-LaBarca ML, Marder G (2011) Antisynthetase syndrome. Curr Rheumatol Rep 13(3):175–181PubMed
35.
Zurück zum Zitat Manfredi A, Sebastiani M, Cassone G et al (2015) Nailfold capillaroscopic changes in dermatomyositis and polymyositis. Clin Rheumatol 34:279–284PubMed Manfredi A, Sebastiani M, Cassone G et al (2015) Nailfold capillaroscopic changes in dermatomyositis and polymyositis. Clin Rheumatol 34:279–284PubMed
36.
Zurück zum Zitat Sebastiani M, Triantafyllias K, Manfredi A et al (2018) FRI0452 Nailfold capillaroscopy in antisynthetase syndrome (NASCAR): results of a multicenter, international study of the american and european network of antisynthetase syndrome (AENEAS). Ann Rheum Dis 77:755–756 Sebastiani M, Triantafyllias K, Manfredi A et al (2018) FRI0452 Nailfold capillaroscopy in antisynthetase syndrome (NASCAR): results of a multicenter, international study of the american and european network of antisynthetase syndrome (AENEAS). Ann Rheum Dis 77:755–756
37.
Zurück zum Zitat Carroll GJ, Withers K, Bayliss CE (1981) The prevalence of Raynaud’s syndrome in rheumatoid arthritis. Ann Rheum Dis 40(6):567–570PubMedPubMedCentral Carroll GJ, Withers K, Bayliss CE (1981) The prevalence of Raynaud’s syndrome in rheumatoid arthritis. Ann Rheum Dis 40(6):567–570PubMedPubMedCentral
38.
Zurück zum Zitat Saraux A, Allain J, Guedes C et al (1996) Raynaud’s phenomenon in rheumatoid arthritis. J Rheumatol 35(8):752–754 Saraux A, Allain J, Guedes C et al (1996) Raynaud’s phenomenon in rheumatoid arthritis. J Rheumatol 35(8):752–754
39.
Zurück zum Zitat Rajaei A, Dehghan P, Amiri A (2017) Nailfold capillaroscopy in 430 patients with rheumatoid arthritis. Casp J Intern Med 8(4):269–274 Rajaei A, Dehghan P, Amiri A (2017) Nailfold capillaroscopy in 430 patients with rheumatoid arthritis. Casp J Intern Med 8(4):269–274
40.
Zurück zum Zitat Bordy R, Totoson P, Prati C et al (2018) Microvascular endothelial dysfunction in rheumatoid arthritis. Nat Rev Rheumatol 14(7):404–420PubMed Bordy R, Totoson P, Prati C et al (2018) Microvascular endothelial dysfunction in rheumatoid arthritis. Nat Rev Rheumatol 14(7):404–420PubMed
41.
Zurück zum Zitat Metisons G, Stavropoulos-Kalinoglou A, Sandoo A (2010) Vascular function and inflammation in rheumatoid arthritis: the role of physical activity. Open Cardiovasc Med J 4:89–96 Metisons G, Stavropoulos-Kalinoglou A, Sandoo A (2010) Vascular function and inflammation in rheumatoid arthritis: the role of physical activity. Open Cardiovasc Med J 4:89–96
42.
Zurück zum Zitat Mosca M, Tavoni A, Neri R et al (1998) Undifferentiated connective tissue disease: the clinical and serological profiles of 91 patients followed at least 1 year. Lupus 7(2):95–100PubMed Mosca M, Tavoni A, Neri R et al (1998) Undifferentiated connective tissue disease: the clinical and serological profiles of 91 patients followed at least 1 year. Lupus 7(2):95–100PubMed
43.
Zurück zum Zitat De Angelis R, Cerioni A, Del Medico P et al (2005) Raynaud’s phenomenon in undifferentiated connective tissue disease (UCTD). Clin Rheumatol 24(2):145–151PubMed De Angelis R, Cerioni A, Del Medico P et al (2005) Raynaud’s phenomenon in undifferentiated connective tissue disease (UCTD). Clin Rheumatol 24(2):145–151PubMed
44.
Zurück zum Zitat Pyrpasopoulou A, Triantafyllou A, Anyfanti P et al (2011) Capillaroscopy as a screening test for clinical antiphospholipid syndrome. Eur J Intern Med 22:e158–e159PubMed Pyrpasopoulou A, Triantafyllou A, Anyfanti P et al (2011) Capillaroscopy as a screening test for clinical antiphospholipid syndrome. Eur J Intern Med 22:e158–e159PubMed
45.
Zurück zum Zitat Sulli A, Pizzorni C, Cutolo M (2000) Nailfold videocapillaroscopy abnormalities in patients with antiphospholipid antibodies. J Rheumatol 27:1574–1576PubMed Sulli A, Pizzorni C, Cutolo M (2000) Nailfold videocapillaroscopy abnormalities in patients with antiphospholipid antibodies. J Rheumatol 27:1574–1576PubMed
46.
Zurück zum Zitat Lehr HÁ (2000) Microcirculatory dysfunction induced by cigarette smoking. Microcirculation 7(6 Pt 1):367–384PubMed Lehr HÁ (2000) Microcirculatory dysfunction induced by cigarette smoking. Microcirculation 7(6 Pt 1):367–384PubMed
Metadaten
Titel
Nailfold capillaroscopy and autoimmune connective tissue diseases in patients from a Portuguese nailfold capillaroscopy clinic
verfasst von
Vera Bernardino
Ana Rodrigues
Ana Lladó
António Panarra
Publikationsdatum
26.08.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Rheumatology International / Ausgabe 2/2020
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-019-04427-0

Weitere Artikel der Ausgabe 2/2020

Rheumatology International 2/2020 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.