Nailfold Videocapillaroscopy Is a Useful Tool to Recognize Definite Forms of Systemic Sclerosis and Idiopathic Inflammatory Myositis in Interstitial Lung Disease Patients

Sambataro, Domenico; Sambataro, Gianluca; Libra, Alessandro; Vignigni, Giovanna; Pino, Fabio; Fagone, Evelina; Fruciano, Mary; Gili, Elisa; Pignataro, Francesca; Papa, Nicoletta Del; Vancheri, Carlo

doi:10.3390/diagnostics10050253

Cited by 16 publications

(13 citation statements)

References 41 publications

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“…Additionally, the IPAF cohort of AHMAD et al [26] was notable for a number of patients with abnormal nailfold capillaroscopy and salivary gland biopsy, investigations not typical of a pulmonologist. In fact, abnormal nailfold capillaroscopy, together with the presence of ILD, may be sufficient to satisfy SSc diagnostic criteria (table 3), removing such cases from the IPAF entity [27]. LEVI et al [28] observed that, following rheumatological review, 40% of selected ILD multi-disciplinary meeting cases received a rheumatology-related ILD diagnosis, including IPAF.…”

Section: Inclusion Of Rheumatological Reviewmentioning

confidence: 99%

Interstitial pneumonia with autoimmune features: challenges and controversies

et al. 2021

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The presence of clinical, serological and/or radiological features suggestive, but not confirmatory, of a defined connective tissue disease in patients with interstitial lung disease is a relatively frequent occurrence. In 2015, the European Respiratory Society and the American Thoracic Society proposed classification criteria for the interstitial pneumonia with autoimmune features (IPAF) research entity to capture such patients in a standardised manner, with the intention of nurturing clinical research. This initiative resulted in the publication of several series of IPAF patients, with significant variation between cohorts in clinical characteristics, outcome and the application of IPAF criteria in patient selection. From this increasing body of published work, it has become apparent that revision of IPAF criteria is now required in order to justify the eventual designation of IPAF as a standalone diagnostic term, as opposed to a provisional entity put forward as a basis for clinical research. This review covers the current state of IPAF, conclusions that can and cannot be drawn from the IPAF evidence base, and ongoing uncertainties that require further expert group consideration.

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Section: Inclusion Of Rheumatological Reviewmentioning

confidence: 99%

Interstitial pneumonia with autoimmune features: challenges and controversies

et al. 2021

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“…These data raise the important question of how to define "abnormal" NFC in ILD populations. Capillaroscopy studies in non-CTD ILD populations are limited, but prior IIP cohorts have reported major nailfold abnormalities in 5.7% to 46.7% [25][26][27]. No non-CTD ILD patients with nailfold abnormalities developed a definable CTD during our study, recognising that diagnostic CTD features can develop many years after ILD onset [2].…”

Section: Discussionmentioning

confidence: 71%

Nailfold capillaroscopy by smartphone-dermatoscope for connective tissue disease diagnosis in interstitial lung disease: a prospective observational study

et al. 2021

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Take home messageNailfold capillaroscopy by smartphone-dermatoscope is a safe, feasible tool that may improve the identification of connective tissue disease in interstitial lung disease further to routine clinical assessment. Methods Study design and participantsConsecutive patients attending a specialist ILD clinic were prospectively screened for inclusion ( 18August 2016 to 24 January 2018). Eligible patients were aged 18 years, with a consensus diagnosis of CTD-ILD or IIP by ILD multidisciplinary-meeting (ILD-MDM), and able to give informed consent.CTD diagnoses were defined by international criteria for systemic sclerosis ( SSc) [3], rheumatoid arthritis (RA) [9], Sjögren's syndrome [10], mixed connective tissue disease [11], idiopathic inflammatory myositis (IIM) [12], and systemic lupus erythematosus [13]. IIPs were defined by American Thoracic Society/European Respiratory Society classification criteria [1, 14]. Of eligible participants, patients meeting IPAF criteria were separately identified [15]. CTD-ILD and IPAF classifications were confirmed by specialist Rheumatologist assessment. Patients unable to provide consent or without CTD-ILD or IIP by ILD-MDM consensus were excluded. Diagnosis at follow-up was censored on 15 June 2020. Ethical approval was granted by the Sydney Local Health District human ethics committee (protocol number X16-0111 HREC/16/RPAH/137). DefinitionsTo delineate a well-defined CTD-ILD cohort for analysis, "CTD-ILD" included only participants fulfilling CTD classification criteria as specified. "Non-CTD ILD" included IIP and IPAF participants. Disease duration was defined as time from onset of symptoms to first clinic presentation.Considering IPAF criteria, participants with positive anti-tRNA synthetase autoantibodies, amyopathic disease, and no other features diagnostic of anti-synthetase syndrome were classified as IPAF. Anti-Ro52, anti-Mi2 and anti-SRP were considered as meeting serological IPAF criteria. "Unexplained vasculopathy" was defined as pulmonary hypertension (PH) on echocardiogram (systolic pulmonary arterial pressure [PAP] >35mmHg above right atrial pressure) [16] or right heart catheterisation (RHC;

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“…The presence of bushy capillaries and/or NVC positivity in ILD patients with normal levels of creatine phosphokinase is associated with amyopathic IIM, regardless the presence of Raynaud's phenomenon (54).…”

Section: Nailfold Videocapillaroscopy (Nvc)mentioning

confidence: 93%

“…dominant involvement on WB-MRI (50, 51). • Specific NVC alterations are associated with different clinical phenotypes (53,54). • Cricopharyngeal bar on VFS has a high specificity for IBM and seem to be a risk factor for aspiration pneumonia (56,57).…”

Section: Nailfold Videocapillaroscopy (Nvc)mentioning

confidence: 99%

Idiopathic inflammatory myopathies: one year in review 2021

Cardelli

Zanframundo

Cometi

et al. 2022

Clinical and Experimental Rheumatology

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Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of rare and complex connective tissue diseases, mainly characterised by inflammatory involvement of skeletal muscles. Several other organs may be affected, particularly lungs, heart, skin, gastrointestinal tract and joints, often determining the morbidity and mortality associated with these autoimmune disorders. The course is generally chronic and the onset subacute. This latter aspect, together with the rarity of these conditions, can result in a clinical challenge for the physician with a considerable diagnostic delay. The scientific literature makes continuous advances in the understanding of these diseases, in particular with regards to the pathogenesis, serological findings, diagnostic strategies and therapeutic approaches. The aim of this review is to highlight the most relevant literature contributions published on this topic over the last year.

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Nailfold Videocapillaroscopy Is a Useful Tool to Recognize Definite Forms of Systemic Sclerosis and Idiopathic Inflammatory Myositis in Interstitial Lung Disease Patients

Cited by 16 publications

References 41 publications

Interstitial pneumonia with autoimmune features: challenges and controversies

Interstitial pneumonia with autoimmune features: challenges and controversies

Nailfold capillaroscopy by smartphone-dermatoscope for connective tissue disease diagnosis in interstitial lung disease: a prospective observational study

Idiopathic inflammatory myopathies: one year in review 2021

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