Nailfold videocapillaroscopy changes in Takayasu arteritis and their association with disease activity and subclavian artery involvement

Javinani, Ali; Pournazari, Mehran; Jamshidi, Ahmad Reza; Kavosi, Hoda

doi:10.1016/j.mvr.2018.10.012

Cited by 11 publications

(13 citation statements)

References 28 publications

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“…They found that the capillary length and venous limb diameter were lower in TA patients as compared to controls. TA patients had more tortuous capillaries; on the other hand, there were no differences in capillary density between the groups [15]. In our study, capillary density was normal in all TA patients and no capillary disorganization was detected.…”

Section: Discussioncontrasting

confidence: 62%

Capillaroscopic findings in Turkish Takayasu arteritis patients

Akdoğan¹,

Erden²,

Şentürk³

et al. 2019

Turk J Med Sci

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Background/aim: Abnormal capillaroscopic findings have been reported in vasculitic syndromes such as Behçet's disease, Henoch-Schönlein purpura, and Wegener's granulomatosis. This study was conducted to define the capillaroscopic changes in patients with Takayasu arteritis (TA). Materials and methods: We studied 28 TA patients (27 females). The nail folds from the 2nd to 5th fingers on both hands were examined with video capillaroscopy for all. A patient was defined as having an abnormal capillaroscopic examination if more than 1 morphologic abnormality was present in at least 2 nail folds. Results: The median capillary density of TA patients was 9 (range: 9-11). There were no patients with capillary disorganization or avascular areas. Tortuous capillaries were detected in all patients. The other common morphological capillary abnormalities included enlarged/dilated capillaries (39.3%), branching capillaries (35.7%), and hemorrhages (32.1%). Only 1 patient had giant capillaries with early scleroderma-like pattern. Overall, there were 11 (39.3%) patients with abnormal capillaroscopic findings. There were more patients with abnormal capillaroscopic findings in the subgroup of TA patients whose upper extremity blood pressure could not be measured as compared to those whose blood pressure could be measured (66.7% vs. 26.3% patients; P = 0.04). Conclusion: Capillaroscopic abnormalities are frequently seen in TA patients. We consider that abnormal capillaroscopic findings in TA patients reflect the impaired blood flow due to narrowed or occluded arteries rather than the primary capillary involvement of the disease process.

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Section: Discussioncontrasting

confidence: 62%

Capillaroscopic findings in Turkish Takayasu arteritis patients

Akdoğan¹,

Erden²,

Şentürk³

et al. 2019

Turk J Med Sci

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“…A recent study revealed that in Takayasu arteritis (TA) capillaries are affected due to hypoperfusion [43]. NFC abnormalities found were reduced capillary length and venous limb diameter and tortuosity, but, in hands with subclavian involvement, these changes were more severe.…”

Section: Large Vessel Vasculitismentioning

confidence: 99%

The Impact of Nailfold Capillaroscopy in the Approach of Microcirculation

Bernardino¹,

Rodrigues²,

Lladò³

et al. 2020

Vascular Biology - Selection of Mechanisms and Clinical Applications

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Nailfold capillaroscopy (NFC) is a simple, validated, and noninvasive method to assess the microcirculation, through direct visualization of the capillaries. Main patterns are classified, according to Cutolo et al., as scleroderma, further divided into early, active, or late patterns, or nonscleroderma. NFC findings include dilated loops, tortuosities, meandering or bushy capillaries, hemorrhage, or architectural distortion. NFC use has been indicated for the evaluation of Raynaud's phenomenon (RP), once it permits the distinction between primary and secondary RP. NFC results accounts for diagnostic criteria of systemic sclerosis, but they can also be useful in staging other connective tissue autoimmune diseases, like systemic lupus erythematosus, inflammatory myositis, or vasculitis. The CSURI index uses NFC for prediction of digital ulcer relapse. Recent evidence revealed NFC can also be applied in systemic disorders with vascular involvement.

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“…Nailfold videocapillaroscopy (NVC) enables us to inspect changes in microvasculature. Only several small uncontrolled case series of light capillary microscopy in adult patients with vasculitis were reported in the literature, describing avascular areas and microhemorrhages in granulomatosis with polyangiitis (GPA) patients [1][2] and in [4] Behcet disease, and thin and tortuous capillaries in Takayasu arteritis [5]. Objectives: To characterize nailfold capillary changes by NVC in patients with autoimmune vasculitis compared to healthy controls.…”

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confidence: 99%

Ab0608 tocilizumab Treatment for Large Vessels Vasculitis: Real Life Preliminary Experiences

Righetti¹,

Venerito²,

Giannotta³

et al. 2019

Abstracts Accepted for Publication

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BackgroundIL-6r targeting therapy has been proven to be effective and safe in Giant Cell arteritis (GCA) as well in Takayasu arteritis (TA) in RCTs, probably because of the similar pathologic findings and vessel size (Large Vessel Vasculitis, LVV). However, real world data are scarce.ObjectivesThe aim of the study was to evaluate the effectiveness of Tocilizumab for LVV in real life settings.MethodsWe retrospectively evaluated, from 2011 to 2017, the outcomes (including glucocorticoid dosage) in patients affected by LVV (according to 1990 aCR classification criteria) who received 8 mg/kg iv Tocilizumab (TCZ) monthly, due to the inadequate response to immunosuppressant. Demographic and clinical characteristics and laboratory findings were collected at baseline and consecutive follow up visits, over 52 weeks. Statistical analysis was performed using the GraphPad Software ver. 6.0 (San Diego CA USA) using appropriate tests.ResultsWe analyzed n.10 patients (6/10 GCA, 4/10 TA) with mean age (± SD) 56 ± 21 years and mean disease duration 41±38 months. Eight out of 10 patients were female. Over the entire observation period, 7/10 also received concomitant methotrexate (mean dose 12.8 ± 2.7 mg/week) while 2/10 received azathioprine (100 mg/day). Median (IQR) prednisone equivalent dose at baseline was 22.5 (10-25) mg/day. At baseline, median ESR was 49 (31-58) mm/h and median CRP level was 15.4 (1.95-28.53) mg/l. Upon TCZ treatment we observed a good disease control in absence of headache, fever and other LVV clinical signs through 52-week follow up. At 52 weeks, we observed a significant reduction of ESR down to 6.5 (2.75-12.25) mm/h as well as of CRP level, down to 1.5 (0.67-3.47) mg/l (p<0.001). A meaningful steroid sparing effect was also achieved as a significant reduction in prednisone dose down to 5 (1.87-6.25) mg/day (p<0.001). During the 52-week follow up period, 3 patients discontinued TCZ treatment for side effects: 1 for severe neutropenia (at 12 weeks), 1 for hemorrhagic pancreatitis (after 24 weeks), and 1 for diverticulitis (after 52 weeks).ConclusionIn our real life experience iv TCZ was effective and safe in LVV treatment, with a good disease control and a significant steroid-sparing effect. Our preliminary findings need to be confirmed in larger cohorts and prolonged follow-up.References[1] Stone JH, Tuckwell K, Dimonaco S, Klearman M, aringer M, Blockmans D, Brouwer E, Cid MC, Dasgupta B, Rech J, Salvarani C, Schett G, Schulze-Koops H, Spiera R, Unizony SH, Collinson N. Trial of Tocilizumab in Giant-Cell arteritis. N Engl J Med. 2017Jul27;377(4):317-328. doi: 10.1056/NEJMoa1613849. PubMed PMID: 28745999.Disclosure of interestsgiulia righetti: None declared, vincenzo venerito: None declared, maria giannotta: None declared, Giuseppe Lopalco Speakers bureau: SOBI, BMS, margherita giannini: None declared, Fabio Cacciapaglia: None declared, Laura Coladonato: None declared, Florenzo Iannone Consultant for: F Iannone has received consultancy fees and/or speaker honoraria from Pfizer, abbVie, MSD, BMS, Novartis,...

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Nailfold videocapillaroscopy changes in Takayasu arteritis and their association with disease activity and subclavian artery involvement

Cited by 11 publications

References 28 publications

Capillaroscopic findings in Turkish Takayasu arteritis patients

Capillaroscopic findings in Turkish Takayasu arteritis patients

The Impact of Nailfold Capillaroscopy in the Approach of Microcirculation

Ab0608 tocilizumab Treatment for Large Vessels Vasculitis: Real Life Preliminary Experiences

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