Background Rheumatic diseases are associated with the increased incidence of cardiovascular diseases.
Objectives The aim of the study was the evaluation of early vascular disorders in children with juvenile idiopathic arthritis based on the capillaroscopic assessment of the nail microcirculation, as biomarker associated with early atherosclerosis.
Methods The study was performed in 56 children with JIA, 4-16 years old, without disease activity, during therapy with at least one disease modifying drug, with or without glucocorticoid. 25 patients had oligoarticular onset of disease, 21 polyarticular onset, 8 had enthesitis-related arthritis and 2 had systemic onset of JIA. The control group consisted of 17 healthy children (age of 4-16 years). The capillaroscopic microvascular assessment using the optic microscope was performed in all patients and controls. The images were analyzed in II - V finger nails of both hands. The evaluation and measurements were made using the software. The analysis of capilaroscopic parameters such as linear capillary density, the percentage of tortuous vessels, presence of avascular areas, disorganized arrangement of capillaries, percentage of abnormal vessels, enlarged and branched vessels, number of microhemorrhages and arterial and venous capillaries width measurements in the fourth finger of non-dominant hand were performed.
Results The presence of microvascular disease symptoms was demonstrated in 62.5% of patients with JIA and 52.6% of the children in the control group. The stage of microvascular complications in JIA group was significantly higher in comparison to the control group. On the basis of score, severity microvascular symptoms in the control group was defined as mild and in JIA group – mild or moderate. The hallmarks of JIA microangiopathy were the increased number of vessels, the presence of branched vessels, disorganization of arrangement of capillaries, lack of avascular areas and correct vessels width. The type of disease onset, duration of the disease, the type of the treatment had no significant effect on the severity of changes in the microcirculation.
Conclusions JIA is associated with the increased capillaroscopic symptoms of microangiopathy that might suggest subclinical atherosclerosis. The severity of the JIA microangiopathy was defined as mild or moderate. It indicates the need for further monitoring. The characteristic features of microangiopathy observed in the inactive phase of JIA were an increased number of vessels, presence of branched vessels and disorganized arrangement of capillaries.
The capillaroscopy is a sensitive tool for assessing the severity of microvascular complications in JIA and should be considered in a non-invasive monitoring also in the aspect of the cardiovascular disease risk.
Disclosure of Interest None declared
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