Background The diagnostic1 and prognostic2 value of nailfold capillaroscopy (NCP) in patients with Raynaud's phenomenon (RP) is well-established. However, its role in the assessment of patients without RP is still unclear.
Objectives We aimed to assess the diagnostic role of NCP in suspected connective tissue disease (sCTD) without RP.
Methods We included all patients with CTD or sCTD submitted to NCP assessment from January 2013 to December 2014. Clinical features were recorded, as well as the presence of antinuclear antibodies (ANA) and extractable nuclear antigens (ENA). NCP results were appraised according to capillary density, presence of dilatations, megacapillaries, hemorrhages, tortuosity, neovascularization and avascular areas. We classified NCP results as normal, nonspecific findings (NSF) and scleroderma pattern (SSP)3. Patients with sCTD were compared according to the presence/absence of RP, ANA/ENA and NCP findings.
Results We included 112 patients: 95 (84.8%) female, with a mean age of 48±18 years. The most frequent CTDs were systemic sclerosis (SSc, n=33, 29.5%) and mixed CTD (n=6, 5.4%). Fifty-eight (51.8%) patients had sCTD – 37 (62.5%) had RP, 26 (55.3%) were ANA positive and 46 (86.8%) were ENA negative. Thirty-three (56.9%) had NSF; one sCTD patient exhibited SSP. Dilatations were present in 27 (51.9%), tortuosity in 40 (76.9%), hemorrhages in 22 (43.2%) and neovascularization in 8 (15.4%) individuals. Patients with and without RP were not different considering clinical features, ANA/ENA positivity and NCP findings (Table 1). The presence/absence of ANA and NCP findings were also not associated with distinct clinical features.
Conclusions RP, ANA positivity and the presence of nonspecific findings in NCP were not discriminant in the short-term assessment of this patient group. Long term follow-up is needed in order to better understand the diagnostic and prognostic role of these NCP findings in both patients with and without RP.
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Blockmans D, et al. Predictive value of nailfold capillaroscopy in the diagnosis of connective tissue diseases. Clin Rheumatol 1996; 15: 148–53.
Cutolo M, et al. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 2000; 27: 155–60.
Disclosure of Interest None declared
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