Possibilities of nailfold capillaroscopy in the differential diagnosis of immuno-inflammatory and rheumatological diseases

Abstract

This article considers capillaroscopic changes in the patients with systemic sclerosis compared to the patients with a group of rheumatological diseases (rheumatoid arthritis, polymyositis, osteoarthritis) and the patients with idiopathic pulmonary hypertension. All the patients diagnosed with systemic sclerosis according to nailfold capillaroscopy had a characteristic combination of capillary disorders (Raynaud’s syndrome): the expansion of all three segments of the capillary loop, the “loss” of capillaries, and the destruction of the nail fold. In the comparison groups, the capillaroscopic picture was represented by single pathological changes that did not add up to the pathognomonic scleroderma patterns, with the exception of the groups with dermato/polymyositis, where 2 patients had significant Raynaud’s syndrome. There were also significant differences in the density of the capillaries in the patients with systemic sclerosis in comparison with the other groups.

Keywords

capillaroscopy / systemic sclerosis / rheumatoid arthritis / polymyositis / osteoarthritis / pulmonary arterial hypertension

References

[1] Maricq HR, LeRoy EC. Patterns of finger capillary abnormalities in connective tissue disease by “wide-field” microscopy. Arthritis Rheum. 1973;16(5):619-628. https://doi.org/10.1002/art.1780160506.

[2] Bollinger A, Jäger K, Roten A, et al. Diffusion, pericapillary distribution and clearance of Na-fluorescein in the human nailfold. Pflugers Arch. 1979;382(2):137-143. https://doi.org/10.1007/bf00584215.

[3] Bukhari M, Herrick AL, Mooreet T, al. Increased nailfold capillary dimensions in primary Raynaud’s phenomenon and systemic sclerosis. Br J Rheumatol. 1996;35(11):1127-1131. https://doi.org/10.1093/rheumatology/35.11.1127.

[4] Grassi W, Core P, Carlino G, et al. Labial capillary microscopy in systemic sclerosis. Ann Rheum Dis. 1993;52(8): 564-569. https://doi.org/10.1136/ard.52.8.564.

[5] Cutolo M, Sulli A, Pizzorni C, Accardo S. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol. 2000;27(1):155-160.

[6] Smith V, Pizzorni C, De Keyser F, et al. Reliability of the qualitative and semiquantitative nailfold videocapillaroscopy assessment in a systemic sclerosis cohort: A two-centre study. Ann Rheum Dis. 2010;69(6):1092-1096. https://doi.org/10.1136/ard.2009.115568.

RIGHTS & PERMISSIONS

Penin I.N., Maslyanskiy A.L., Konradi A.O., Mazurov V.I.