Assessment of morphology and distribution of capillaries in patients with SSc and healthy individuals in nailfold capillaroscopy
Abstract
Introduction: Systemic sclerosis (SSc) is a connective tissue disease characterized by vascular damage and immunological abnormalities leading to fibrosis that can damage multiple organs. The pathogenesis is complex and still poorly understood. However impaired angiogenesis in SSc has a major role in tissue injury and sequelae fibrosis. Nailfold capillaroscopy (NC)/nailfold videocapillaroscopy (NVC) is safe and non-invasive methods used to investigate microvascular changes in the peripheral circulation and it is a method of great diagnostic value in diagnosing and monitoring the patients with SSc. Typical microvascular alterations, called scleroderma pattern characterized by giant capillaries, haemorrhages and successive loss of capillaries, are observed at NC/NVC in a significant percentage of SSc patients, hence our interest was focused on the assessment of NVC in patient with systemic sclerosis (SSc).
Material and methods: Thirty patients with SSc according to the ACR and EULAR criteria and healthy volunteers underwent NVC assessment. Nailfold capillaroscopy was performed by a videocapillaroscope and the picture of the capillaries at the hands were documented and evaluate. Results: NVC disturbed patterns were significantly prominent in SSc patients (p < 0.05) compared to the healthy control group. A normal capillaroscopic pattern was not observed in patients with SSc. The number of loops/mm was significantly lower in SSc group (p < 0.05) and was 4.28 capillaries/mm (min.1/mm; max. 10/mm). We did not notice significant difference in frequency of mega-capillaries (lcSSc/dcSSc: 41%/29%, p > 0.05) and avascular areas (lcSSc/dcSSc: 64%/57%, p > 0.05) between limited (lSSc) and diffuse (dSSc) SSc.
Conclusions: Severe capillary damage is characteristic for SSc patients therefore NVC seems to be useful for selection of patients developing SSc.
Keywords: systemic sclerosisnailfold capillaroscopyconnective tissue disease
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