Nailfold capillaroscopy in rheumatology: ready for the daily use but with care in terminology

Cutolo, Maurizio; Paolino, Sabrina; Smith, Vanessa

doi:10.1007/s10067-019-04716-w

Cited by 24 publications

(17 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…NVC is to date the best tool to analyze microvascular abnormalities in CTDs [ 17 , 18 ]. Additionally, NVC alterations in course of SSc are well-defined and correlate with organ involvement and disease progression, in contrast to other CTDs—such as in SLE, SjS, MCTD, and IIM—in which NVC alteration is less disease-specific [ 19 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

Antiphospholipid antibodies and anticoagulant therapy: capillaroscopic findings

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by specific vascular and obstetric manifestations and by antiphospholipid antibodies (aPL) positivity. Microvascular damage in the course of APS and “aPL carrier” patients without symptoms is poorly investigated. Objectives This study aims to compare nailfold videocapillaroscopy (NVC) microvascular parameters in APS patients and non-symptomatic "aPL carriers" and to investigate their possible correlations with different aPL subtypes. Methods NVC was performed during standard evaluations in 18 APS patients (mean age 50 ± 13.8 years), 24 "aPL carriers" without symptoms (mean age 46.4 ± 16.4 years), and 18 control patients (CTR) (mean age 74 ± 12.5 years) taking oral anticoagulants for non-immunological indications (i.e., cardiovascular accidents). All patients were investigated for the presence of dilated capillaries, giant capillaries, microhemorrhages, capillary loss, and further non-specific/specific abnormalities (i.e., branched “bushy” capillaries, sign of neoangiogenesis) by NVC. Every alteration was also classified according to a semi-quantitative score. Lupus anticoagulant, anticardiolipin antibodies, and antibeta2 glycoprotein I antibodies were tested in each patient. Results APS patients showed at NVC increased frequency of microhemorrhages (p = 0.039)—particularly a “comb-like” pattern (parallel hemorrhages) (p = 0.002)—than "aPL carriers". Of note, there were no significant differences concerning the isolated number of microhemorrhages between APS and the CTR group (p = 0.314), but “comb-like” hemorrhages were significantly more frequent in the APS group (p = 0.034). Not any significant correlation was found between the aPL subtypes and NVC parameters. Conclusions APS patients showed significantly a greater number of non-specific NVC abnormalities than "aPL carriers", particularly the “comb-like” NVC pattern. Oral anticoagulants may represent a confounding factor for isolated microhemorrhages. Not any correlation was found between aPL subtypes and NVC parameters. Further investigations are needed to better characterize the microvascular endothelium damage induced by aPL.

show abstract

Section: Discussionmentioning

confidence: 99%

Antiphospholipid antibodies and anticoagulant therapy: capillaroscopic findings

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…In another research, Lin et al outlined that, in the RA population, elongated and tiny capillaries and capillary tortuosity are the most specific discoveries and that the subpapillary venous plexus was present mostly in RA patients who were ANA-positive [ 128 ]. Cutolo et al indicated that a “scleroderma-like” capillaroscopic pattern might be described in patients with RA, particularly when rheumatoid vasculitis is present [ 129 ].…”

Section: Inflammation and Atherosclerotic Burden In Rheumatoid Arthritismentioning

confidence: 99%

Ischemic Heart Disease and Rheumatoid Arthritis—Two Conditions, the Same Background

Rezuş

Macovei

Burlui

et al. 2021

Life

View full text Add to dashboard Cite

Rheumatoid arthritis (RA) is one of the most frequent inflammatory rheumatic diseases, having a considerably increased prevalence of mortality and morbidity due to cardiovascular disease (CVD). RA patients have an augmented risk for ischemic and non-ischemic heart disease. Increased cardiovascular (CV) risk is related to disease activity and chronic inflammation. Traditional risk factors and RA-related characteristics participate in vascular involvement, inducing subclinical changes in coronary microcirculation. RA is considered an independent risk factor for coronary artery disease (CAD). Endothelial dysfunction is a precocious marker of atherosclerosis (ATS). Pro-inflammatory cytokines (such as TNFα, IL-1, and IL-6) play an important role in synovial inflammation and ATS progression. Therefore, targeting inflammation is essential to controlling RA and preventing CVD. Present guidelines emphasize the importance of disease control, but studies show that RA- treatment has a different influence on CV risk. Based on the excessive risk for CV events in RA, permanent evaluation of CVD in these patients is critical. CVD risk calculators, designed for the general population, do not use RA-related predictive determinants; also, new scores that take into account RA-derived factors have restricted validity, with none of them encompassing imaging modalities or specific biomarkers involved in RA activity.

show abstract

“…Nailfold capillaroscopy is useful not only for the diagnosis of SSc but also for the diagnosis and monitoring of scleroderma-spectrum diseases, including dermatomyositis (DM), polymyositis (PM), mixed connective tissue disease (MCTD) and undifferentiated connective tissue disease (UCTD) [ 3 ]. According to Cutolo et al [ 2 ], the capillaroscopic abnormalities characteristic of SSc occurring in other “scleroderma-spectrum” diseases should be defined as “scleroderma-like pattern” microangiopathy, which affects about 20–40% of patients with idiopathic inflammatory myopathies, more often in DM than in PM. The predominant capillaroscopic changes in DM include increased neoangiogenesis (bushy, dendriform vessels) and moderate derangement of the vascular architecture with a relatively low number of avascular areas.…”

Section: Nailfold Capillaroscopy In Scleroderma-spectrum Disordersmentioning

confidence: 99%

“…In SSc, the capillaroscopic examination shows characteristic microcirculation disturbance called microangiopathy typical of SSc “scleroderma pattern”. The term microangiopathy includes the following pathological changes: dilated capillary loops leading to formation of megacapillaries, decreased numbers of vessels, the areas of avascularisation, and the presence of ramified loops and microhaemorrhages [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

The usefulness of nailfold capillaroscopy in “scleroderma-spectrum” disorders

Wielosz¹

2021

Reumatologia

View full text Add to dashboard Cite

Nailfold capillaroscopy is a non-invasive method for visualising the nailfold capillaries under a stereomicroscope or videocapillaroscope. The examination is used for differential diagnosis of Raynaud`s phenomenon and microcirculation disorders in secondary Raynaud’s phenomenon associated with systemic connective tissue diseases [1]. <br /> Capillaroscopy is particularly important for early diagnosis of systemic sclerosis (SSc) for assessing the disease activity and the extent of internal organ involvement as well as for monitoring and evaluating the effectiveness of the therapy applied. In SSc, the capillaroscopic examination shows characteristic microcirculation disturbance called microangiopathy typical of SSc “scleroderma pattern”. The term microangiopathy includes the following pathological changes: dilated capillary loops leading to formation of megacapillaries, decreased numbers of vessels, the areas of avascularisation, and the presence of ramified loops and microhaemorrhages [2].

show abstract

Nailfold capillaroscopy in rheumatology: ready for the daily use but with care in terminology

Cited by 24 publications

References 43 publications

Antiphospholipid antibodies and anticoagulant therapy: capillaroscopic findings

Antiphospholipid antibodies and anticoagulant therapy: capillaroscopic findings

Ischemic Heart Disease and Rheumatoid Arthritis—Two Conditions, the Same Background

The usefulness of nailfold capillaroscopy in “scleroderma-spectrum” disorders

Contact Info

Product

Resources

About