A Case of Pseudoxanthoma Elasticum with Microvascular Alterations: Possible Explanations and Causes

Stumpf, Max Jonathan; Steinmetz, Martin; Skowasch, Dirk; Nickenig, Georg; Schahab, Nadjib; Alex, Christian; Schaefer, E.L.

doi:10.4172/2161-0533.1000236

Cited by 1 publication

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“…Besides these main characteristics, PXE has been connected to interstitial, restrictive lung disease [10] and microvascular alterations [11][12][13]. Chen et al described a case of PXE with morphological changes of nailfold capillaries in 2002 [11].…”

Section: Introductionmentioning

confidence: 99%

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Pseudoxanthoma elasticum – also a microvascular disease

Stumpf

Mahn

Steinmetz

et al. 2020

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Summary: Background: Pseudoxanthoma elasticum (PXE) is a heritable recessive disease characterized by calcification and fragmentation of soft connective tissue. Besides progressive loss of vision, alternations of the skin, and early-onset atherosclerosis different reports have suggested a microvascular manifestation of PXE and restrictive lung disease. Aim of this study was to elaborate a specific pattern of capillary alterations in PXE as well as to contemplate a possible connection to restrictive lung disease. Patients and methods: 53 consecutive patients with PXE and 26 controls were studied. All patients underwent nailfold capillaroscopy, body plethysmography, capillary blood gas analysis, and venous puncture to assess titer of autoantibodies. Results: PXE was associated with highly pathological alterations of capillaries compared to control. Atypical capillaries, such as ramifications and bushy forms, as well as dilatations varied at highest significance (p < .001). This effect was mirrored by perivascular edema, density and tortuous capillaries. Titer of anti-nuclear autoantibodies were not elevated in patients with PXE. Further analysis revealed negative correlation between vital capacity and presence of atypical capillaries. Conclusions: This study firstly describes the pattern of nailfold capillaries in PXE. Capillaries are highly pathological and consist of ramifications and bushy forms as well as dilatations. Frequently, tortuous capillaries, pericapillary edema and reduced denseness of capillary loops occur. Frequency of atypical capillaries is negatively correlated with vital capacity which can be interpreted as further lead on restrictive lung disease.

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Section: Introductionmentioning

confidence: 99%

“…Alterations consisted of perivascular edema, torsions and several atypical capillaries such as dilations, ramifications and elongations. It was hypothesized that formation of altered capillaries may be related to local hypoxia induced by a thickening of capillary basement membrane [13].…”

Section: Introductionmentioning

confidence: 99%