Capillaroscopy – a role in modern rheumatology

Chojnowski, Marek; Felis-Giemza, Anna; Olesińska, Marzena

doi:10.5114/reum.2016.60215

Cited by 84 publications

(83 citation statements)

References 20 publications

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“…In fact, the European League Against Rheumatism (EULAR) 2013 criteria have included the SS NFC pattern as a major diagnostic criterion. In more than 95% of patients with SS, microangiopathy exhibits a typical pattern that can classify disease in its ‘early’, ‘active’ and ‘late’ phases 12. In our patient, NFC confirmed abnormalities compatible with late SS.…”

Section: Discussionsupporting

confidence: 61%

“…The NFC’s associated high negative predictive value has great clinical importance in the exclusion of SS 13. NFC results suggestive of SS can be found in other connective tissue disorders, such as dermatomyositis and mixed CTD (MCTD) 12. However, given the global clinical picture and the specific NFC findings in our patient, these other possibilities were excluded.…”

Section: Discussionmentioning

confidence: 74%

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Systemic sclerosis: severe pulmonary arterial hypertension and pericardial effusion at diagnosis

Moniz¹,

Rei

Rodrigues

et al. 2018

BMJ Case Reports

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A 51-year-old female patient with a recent hospital admission reported to the emergency room (ER) with progressive worsening of fatigue, dyspnoea and chest discomfort. She had been recently admitted and discharged with the diagnosis of pericarditis and medicated with non-steroidal anti-inflammatory drugs and diuretics. She returned to the ER with persisting symptoms. Echocardiography was repeated and showed signs of elevated right ventricular systolic pressure and a slightly increased moderate/severe pericardial effusion without signs of cardiac tamponade. The patient was admitted and further evaluation confirmed an underlying case of advanced systemic sclerosis with skin, vascular, pulmonary and cardiac involvement. The patient was referred to specialised consults in autoimmune pathology and pulmonary arterial hypertension. She was started on bosentan and corticosteroids, presenting a favourable clinical evolution although symptoms of exertional dyspnoea persist.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 74%

Systemic sclerosis: severe pulmonary arterial hypertension and pericardial effusion at diagnosis

Moniz¹,

Rei

Rodrigues

et al. 2018

BMJ Case Reports

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“…The following morphological measurements were considered: alterations in capillary length (normal length [normal values are 200–500 μm], increased length, or reduced length), distribution (ordered, comma-like, irregular, or severely deranged), morphology (hairpin, tortuous, ramified, or bushy capillaries), capillary density (10–30/mm 2 , 8–10/mm 2 , or <8/mm 2 ), diameter (normal, enlarged loop, or giant loop), hemorrhages (absent, in a few areas, or diffuse), and flux abnormalities (normal, slow, or discontinuous). [8,12] Representative images of the NVC alterations are shown in Fig. 1.…”

Section: Methodsmentioning

confidence: 99%

“…[6–8] NVC is used to evaluate the morphology, distribution, density, and blood flow of nailfold dermal papillary capillaries. However, diabetic microangiopathy is a frequent and often early complication that mainly involves the retinal and renal microcirculations.…”

Section: Introductionmentioning

confidence: 99%

Nailfold capillary abnormalities are associated with type 2 diabetes progression and correlated with peripheral neuropathy

et al. 2016

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Diabetes mellitus (DM) is associated with a state of chronic hyperglycemia with a highly increased risk of vascular complications. The current study aimed to investigate microcirculation abnormalities in patients with type 2 DM and those with pre-DM using nailfold videocapillaroscopy (NVC) and evaluate the possible correlation with microvascular complications.A total of 115 patients with type 2 DM, 41 patients with pre-DM, and 37 healthy subjects without diabetes were enrolled. All subjects underwent NVC to evaluate capillary density, length, morphology, distribution, presence of enlarged loops or hemorrhages, and blood flow. NVC score was used to quantitate the aforementioned characteristics.Patients with type 2 DM showed significantly increased alterations including reduced capillary length (29.6%), irregular distribution (35.7%), and abnormal morphology (59.1%), while the corresponding NVC scores were comparable to those of control subjects. In addition, subjects with pre-DM had a significantly higher NVC score and greater alterations in distribution (26.8%) and morphology (48.8%) than control subjects. NVC score was positively correlated with diabetic peripheral neuropathy (DPN) and the number of microvascular complications.NVC identified a high frequency of microcirculation abnormalities in subjects with pre-DM or type 2 DM compared to those in the control group. NVC score was also capable of detecting microvascular complications in patients with type 2 DM and was correlated with DPN and the number of microvascular complications.

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“…The ‘early’ capillaroscopic scleroderma pattern observed in RP patients can preexist for many years without any other symptoms, before the full onset of SSc [15]. A similar phenomenon may occur in esophageal dysmotility.…”

Section: Significance Of Esophageal Transit Study In Systemic Sclerosismentioning

confidence: 99%

Esophageal transit scintigraphy in systemic sclerosis

2016

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Systemic sclerosis is a rare connective tissue disease, distinctive features of which are fibrosis and microangiopathy. The esophagus is one of the most commonly involved internal organs. Most patients experience dysphagia, difficulties in swallowing and gastro-esophageal reflux. However, in up to one third of cases, the initial onset of esophageal disease may be clinically silent. There are several diagnostic modalities available for assessing both morphological and functional abnormalities of the esophagus. If structural abnormalities are suspected, endoscopy is the method of choice. Functional evaluation is best achieved with manometry. Both endoscopy and manometry are invasive techniques, with low patient acceptance. Barium-contrast study is well tolerated, but qualitative assessment of functional abnormalities is imprecise. Esophageal scintigraphy is an easy, non-invasive, sensitive and specific diagnostic modality. It can detect esophageal dysfunction even in asymptomatic patients. In patients already diagnosed with systemic sclerosis, scintigraphy is useful in evaluating severity and progression of the disease.

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Capillaroscopy – a role in modern rheumatology

Cited by 84 publications

References 20 publications

Systemic sclerosis: severe pulmonary arterial hypertension and pericardial effusion at diagnosis

Systemic sclerosis: severe pulmonary arterial hypertension and pericardial effusion at diagnosis

Nailfold capillary abnormalities are associated with type 2 diabetes progression and correlated with peripheral neuropathy

Esophageal transit scintigraphy in systemic sclerosis

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