Background Nailfold videocapillaroscopy (NVC) is an easy, fast and non-aggressive tool, useful in the study of autoimmune diseases. The use of NVC in Inflammatory Myopathy (IM) is not clearly established.
Objectives 1. To evaluate capillaroscopic findings in patients with IM and/or with presence of specific or associated antibodies with this pathology. 2. To analyze possible relationships with clinical characteristics of the patients.
Methods Retrospective review of a cohort of patients with IM and/or with presence of specific or associated antibodies, followed in Rheumatology Unit of a University Hospital.
Patients underwent a NVC at 200x, being evaluated for the presence of: loss of capillary density, enlarged and giant capillaries, ramified capillaries, haemorrhages, thrombosis, tortuous capillaries, avascular areas, disorganization of capillary architecture and subpapilar venous plexus. The following variables were also collected: sex, age, active smoking, muscle weakness, CK elevation at diagnosis, compatible muscle EMG and biopsy, skin findings, cardiac disease, dysphagia, lung disease, Raynaud's phenomenon, cancer history and overlap syndromes.
For the comparison of qualitative and/or quantitative variables Fisher's exact Test or T-test was performed when necessary.
Results Twenty patients with at least one NVC (45% with 2), 65% female, with a mean age of 58 years ± 11.6 were evaluated. The characteristics of the patients are detailed in table 1.
65% of patients had some capillaroscopic alteration. The findings in NVC-1 and NVC-2 were: loss of capillary density 30% and 33%, tortuous capillaries 90% and 89%, enlarged capillaries 65% and 66.7% (giants 30% and 33%), ramifications 40% and 55.6%, disorganization 10% and 33%, haemorrhages 25% and 44%, thrombosis 20% and 0%, avascular areas 25% and 22%, visible venous plexus 40% and 55%.
The presence of dysphagia was associated with the presence of loss of capillary density (p<0.02) and haemorrhages (p<0.01) in the initial NVC, as well as the presence of ramifications in the control NVC (p<0, 05).
It was observed that patients with normal capillary organization presented better value of FVC (p<0.01), TLC (p<0.01), and lower FEV1/FVC ratio (p<0.02), the latter finding also found in control NVC (p<0.03). As additional data, we found that patients with anti-Ku+ presented better values of FVC (p<0.04) and TLC (p<0.05), but although they all had normal capillary organization, the association of this antibody with NVC was not statistically significant. We also did not find a statistically significant relationship between the alterations in NVC and the presence of Raynaud's phenomenon, the other clinical variables, cancer history and the presence of overlap syndromes.
Conclusions Patients with capillary disorganization in NVC showed worse values of FVC, TLC and FEV1/FVC. We found a statistically significant association between esophageal disease and haemorrhages, loss of capillary density and ramifications. Prospective studies with larger sample sizes are required to define the usefulness of NVC in the diagnosis, prognosis and follow-up of these patients.
Disclosure of Interest None declared