Predictive value of nailfold capillaroscopy in the diagnosis of connective tissue diseases

Abstract

We revised the clinical files of 326 patients who underwent nailfold capillaroscopy. These patients could be subdivided into 4 groups: I: patients with clinical suspicion of connective tissue disease, II: patients with isolated Raynaud's phenomenon, III: patients with existing connective tissue disease, IV: patients with acrocyanosis, chronic pernio or related disorders. The presence of megacapillaries was noted. The sensitivity of their presence for the various categories of connective tissue disease was as follows: systemic sclerosis (n = 11): 100%, CREST (n = 15): 73%, MCTD (n = 9): 56%, dermatomyositis (n = 7): 86%. Nineteen patients with megacapillaries had no final diagnosis of connective tissue disease (specificity 93.3%). The positive predictive value of the presence of megacapillaries for a scleroderma spectrum disorder (SSD) was 63.5% and the negative predictive value of a normal capillaroscopy 96.7%. We conclude that nailfold capillaroscopy can be advised to rule out SSD's.

TNFα-308A allele in juvenile dermatomyositis: Association with increased production of tumor necrosis factor α, disease duration, and pathologic calcifications

“…The choice of medical therapy was based on the clinical examination and the laboratory data. This information included data on the standard muscle enzymes as well as the special laboratory indicators of immunologic activation, the extent of vascular involvement seen on muscle biopsy at diagnosis (27), and the nailfold capillary changes at referral (28). The type and amount of medical therapy usually consisted of intravenous methylprednisolone at 30 mg/kg/day supplemented by 0.5 mg/kg oral prednisolone on nonintravenous corticosteroid days.…”

Nail fold capillaroscopy in patients of systemic sclerosis and its association with disease severity as evidenced by high resolution computed tomography lung: a hospital based cross sectional study

“…5 The peripheral microangiopathy in SSc patients may be well recognized and studied by nailfold capillaroscopy, a non-invasive and safe technique, which is well reported to have both diagnostic and prognostic values in the presence of RP. [6][7][8][9][10][11] Nowadays , abnormal nail fold capillaries has been accepted as the part of new classification criteria for SSc. 12 Pulmonary involvement in SSc manifests itself as interstitial lung disease (ILD) and Pulmonary hypertension.…”

Nail fold videocapillaroscopy in mixed cryoglobulinaemia

“…Certain vascular abnormalities may be detected in several connective tissue diseases. For instance, the enlargement of the entire capillary loop and loss of blood vessels are observed in patients with dermatomyositis and, even more often, with scleroderma [12]. However, while individually non-specific, the abnormalities detected in MC could be clustered in a pattern of tortuous and short capillaries with abnormal orientations and with neoangiogenetic shapes, which is consistent with a high degree of deterioration of nutritional circulation.…”

“…The predictive value of nail fold capillaroscopy in the diagnosis and monitoring of some connective tissue diseases has been definitely established [12]. NVC analysis has proven to be particularly useful in evaluating the progression of sclerodermic microangiopathy [9].…”