Background One indicator of the active microvascular damages of juvenile dermatomyositis (JDM) is enlarged nailfold capillary (NFC). We have reported that serum FDP–E level is a marker of fibrinogenolysis and reflects maicroangiopathy in JDM patients.
Objectives To determine clinical factors associated with the rates of enlarged NFCs.
Methods Forty NFC images of fifteen JDM patients (7.3±3.9 years at first visit) were evaluated. NFC findings of 4 fingers of hand, excluding thumb were recorded in maintaining a constant room temperature of range 24–26°C. The rates of enlarged capillaries (>20 μm) to total number of end raw loops per millimeter in 4 digits were evaluated. Correlations between the rates of enlarged NFCs and serum level of CK, aldorase, FDP-E and ESR were examined. Associations between clinical manifestations (skin involvemrnts and muscle weakness) and the rates of enlarged NFCs were also evaluated. The rates of enlarged NFCs were devided into four groups in this study (group 1=0∼25%, group 2=26∼50%, group 3=51∼75%, group 4=76∼100%), and rates of abnormal levels of serum CK, aldolase, FDP-E, and ESR were evaluated, respectively.
Results The rates of enlarged NFCs were significantly associated with serum FDP-E levels (r=0.34, P<0.05). Skin involvements were associated with higher rates of enlarged NFCs. Furthermore, abnormal FDP-E levels were found in 33% in group 1, whereas in group 4 abnormal FDP-E levels were found in all patients (p=0.0034).
Conclusions Enlarged NFCs may reflect microangiopathy in active disease of JDM. Serum FDP-E levels will indicate microvascular inflammation especially in skin involvements.
Takayuki K, et al. Clinical analysis of juvenile dermatomyositis; a retrospective study of 45 Japanese. Eular congress. 2009
Disclosure of Interest None Declared