Impaired quantitative cerebral blood flow in scleroderma patients

Nobili, Flavio; Cutolo, Maurizio; Sulli, Alberto; Castaldi, Antonio; Sardanelli, Francesco; Accardo, S; Rosadini, G; Rodriguez, Guido

doi:10.1016/s0022-510x(97)00144-5

Cited by 34 publications

(18 citation statements)

References 33 publications

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“…Cerebral hypoperfusion, suggestive of impaired microcirculation, was recently observed in sclerodermic patients. 6 However, pathological studies have failed to demonstrate primary cerebrovascular changes in systemic sclerosis. Nonspecific cortical ne- crotic foci were reported in 3 of 17 brains.…”

Section: Discussionmentioning

confidence: 99%

Brain Involvement in Scleroderma

Héron

Fornès

Rance

et al. 1998

Stroke

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Background-Neuropathological data are very scarce in systemic sclerosis and fail to demonstrate primary changes in the brains of such patients. Case Descriptions-A 41-year-old woman with CREST syndrome developed signs of dementia after an episode of severe dehydration and died two months later of septic shock. A 63-year-old woman with CREST syndrome and a history of two unexplained transient ischemic attacks had had balance disorders since age 62. She died of severe pulmonary hypertension. In both cases, the autopsy showed extensive wall calcification of small arteries and arterioles in the brain, primarily in the basal ganglia, and also in the frontal lobes and the cerebellar area in the second case. No known cause of cerebrovascular calcification was found in either patient. Conclusion-The neuropathological findings in these two patients suggest that systemic sclerosis may induce primary vascular changes in the brain, of which calcification may be a marker. (Stroke. 1998;29:719-721.)

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Section: Discussionmentioning

confidence: 99%

Brain Involvement in Scleroderma

Héron

Fornès

Rance

et al. 1998

Stroke

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“…The NVC patterns have been correlated with different clinical aspects and manifestations of SSc, as well as to the effects of treatment, contributing to the overall study of the disease [32][33][34][35][36].…”

Section: The "Scleroderma-pattern": the Reference Patternmentioning

confidence: 99%

Nailfold video-capillaroscopy in systemic sclerosis

2004

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The Raynaud's phenomenon (RP) is the most common and significant clinical condition supporting microvascular analysis as soon as possible. Microvascular involvement is a key feature of RP, and several rheumatic diseases are characterized by the presence of the RP. Nailfold capillary microscopy shows an impressive cost/effectiveness ratio: it is simple, noninvasive and inexpensive.Well-recognized videocapillaroscopic patterns (NVC) have been described mainly in scleroderma (SSc) patients complaining of a secondary RP. The peripheral microvascular damage in SSc is characterized by increasing structural alterations of the capillaries (giant capillaries and microhemorrhages) with progressive decrease of their density. The detection of the scleroderma NCV allows early differentiation between primary RP (functional, not disease associated), and secondary RP (disease associated). Other major NVC patterns have been described in the field of rheumatic diseases. Interestingly, correlations are evident between the NCV and the clinical symptoms, severity of the disease and the laboratory findings. Further clinical and epidemiological studies, as well as a standardized and computerized quantitation of the observed damages are required.

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“…Indeed, different patterns were found to be related with different disease durations in this connective tissue disease. Moreover, cerebral hypoperfusion assessed by 133-xenon fluximetry along with single-photon emission computed tomography analysis has been recently reported to be related to major NVC patterns seen in scleroderma [13]. The relationship between changes induced by the same disease in two microcirculation systems, i.e.…”

Section: Discussionmentioning

confidence: 99%

Nail fold videocapillaroscopy in mixed cryoglobulinaemia

Rossi¹,

Mansouri²,

Baldovino³

et al. 2004

Nephrology Dialysis Transplantation

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Background. Nail fold videocapillaroscopy (NVC) has been extensively used to examine morphological and functional changes of microcirculation in connective tissue diseases. The nutritional circulation that depends on tissue capillaries, can be expected to be significantly impacted in mixed cryoglobulinaemia (MC). Methods. Using NVC, we evaluated 29 patients with MC (19 women), mean age 66 years (range 40-83). They included 28 hepatitis C virus (HCV) positive patients-14 genotype 1b, 10 genotype 2a 2c, two genotype 4, two with undetermined genotype. Of them, 18 had type II (IgMk-IgG) MC and 11 had type III. All patients were symptomatic, presenting with weakness (24 of 29 patients), arthralgia (24), purpura (16), peripheral neuropathy (20), Raynaud's phenomenon (8), hypertension (19) and membranoproliferative glomerulonephritis (MPGN) (9). The nail fold capillaries of four fingers per hand were examined using a videomicroscope. Results. Of the 29 patients, 27 had morphological abnormalities (including tortuosity and apical enlargement), 18 had capillaries with deeply altered orientations, 17 had shortened capillaries and 20 neoangiogenetic phenomena. These four types of capillary abnormalities were simultaneously present in 10, suggesting this combination to be a characteristic pattern in MC. Less common alterations included haemorrhages (10 cases), enlarged and giant capillaries (2) and avascular areas (2). The patients with MCassociated MPGN had a significantly greater number of capillary abnormalities (mean 4.5, range 4-6) than non-nephritic patients (mean 3.5, range 1-6, P ¼ 0.01). The number of capillary abnormalities was not related to the presence of Raynaud's phenomenon.Microcirculatory changes did not correlate with other clinical manifestations or serological indices, including cryocrit, cryoglobulin type, HCV genotype, viral load, haemoglobin, ALT, rheumatoid factor, IgM and C4 levels.Conclusions. Patients with MC show a variety of microcirculatory changes, often clustered in a characteristic pattern of abnormally oriented, short capillaries and neoangiogenetic phenomena. Capillary changes are more numerous in nephritic patients.

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Impaired quantitative cerebral blood flow in scleroderma patients

Cited by 34 publications

References 33 publications

Brain Involvement in Scleroderma

Brain Involvement in Scleroderma

Nailfold video-capillaroscopy in systemic sclerosis

Nail fold videocapillaroscopy in mixed cryoglobulinaemia

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