AB0807 Nailfold capillaroscopy findings are related to the pulmonary function tests values in patients with systemic sclerosis

Abstract

Objectives To determine the relation between different pathological capillaroscopic findings and pulmonary function tests in patients with scleroderma. Methods Retrospective observational study of a cohort of patients with systemic sclerosis (SSc) or early SSc (eSSc) followed in Rheumatology Unit of a University Hospital from 1975 to 2011. Patients who had a nailfold videocapillaroscopy with 120x magnification were selected. The following pathological findings were considered: presence of megacapillaries and/or angiogenesis and loss of capillary density. Capillaroscopic findings were compared with the following values of lung function tests performed in the same year of the capillaroscopy: % predicted forced vital capacity (FVC), DLCO and the FVC/DLCO ratio. The following variables were also included: sex, type of SSc, presence of digital ulcers, interstitial lung disease (ILD), scleroderma renal crisis (SRC) and pulmonary hypertension determined by echocardiogram. Statistical analysis was performed by T Test to compare the capillaroscopic findings and pulmonary function test. Values of p<0.05 were considered statistical significance. Results Of all patients (n=136), 84 had at least one videocapillaroscopy. We observed that 92,9% were female, 67% (57/84) had limited SSc, 25,3% (21/84) ILD, 29,8% (25/84) DU and 17,9% (15/84) of patients had PH. We analyzed the capillaroscopics findings with the lung function parameters. We found that patients with loss of capillary density had worse FVC (87% ± 19,58 vs 101,12% ± 16,06, p <0.01) and DLCO (71,24% ± 21,37 vs. 85,9% ± 19,81, p <0.01). We did not find a relation between alteration in respiratory function tests and the presence of megacapillaries and angiogenesis. Conclusions Patients with significant loss of capillary density in the nail-fold capillaroscopy showed worst values of FVC and DLCO. Prospective studies are needed to determine if the nail-fold capillaroscopy may be useful to study lung involvement in patients with systemic sclerosis. Disclosure of Interest None Declared

The role of nailfold capillaroscopy in monitoring lung involvement in systemic sclerosis

“…A progressive loss of capillaries from baseline predicted overall disease progression, new DU, lung vascular progression defined as new onset of precapillary PAH, skin fibrosis and worsening in the Medsger severity score. Similarly, Castellvi et al (10) described an association between low capillary density and lower FVC and DLCO percentages using a semi-quantitative NVC.…”

“…Moreover, ramified/bushy capillaries score together with diffused SSc were independent risk factors for the presence of ILD (9). Patients with significant loss of capillary density showed worst values of FVC and DLCO (10). The group of Reyes-Reuda also found positive association between abnormal capillaroscopy and interstitial lung disease but no correlation with PAH (11).…”