Article
Nailfold capillaroscopy in assessing vascular manifestations of systemic sclerosis in patients with pulmonary arterial hypertension
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Authors
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Natalia Yudkina
- V.A. Nasonova Scientific Research Institute of Rheumatology, Diagnostic Department, Moscow
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Alexander Volkov
- V.A. Nasonova Scientific Research Institute of Rheumatology, Diagnostic Department, Moscow
| Published: | September 14, 2021 |
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Outline
Text
Introduction: Pulmonary arterial hypertension (PAH) is one of the main manifestations of vascular involvement in the microvasculature in systemic sclerosis (SSc). Considering the severity of PAH in SSc and low patient survival, the study of the possible relationship between pathogenetically related processes may play a predictive role in the early diagnosis of PAH and digital ischemic disorders by nailfold capillaroscopy of the periungual bed.
Methods: 116 patients with SSc (51 patients with PAH (SSc-PAH) and 65 patients with without PAH). The nailfold capillaroscopy assessed the presence of capillaroscopic changes in the periungual bed on 2-5 fingers of both hands. The normal capillaroscopic pattern was characterized by the presence of 7-11 hairpin-shaped capillaries per 1 mm. The capillaroscopy pattern (normal/early/active/late) was qualitatively identified.
Results: The early scleroderma pattern was diagnosed in 17 patients with SSc-PAH and in 16 patients with SSc without PAH. The active scleroderma pattern was revealed in 14 patients with SSc-PAH and in 8 patients with SSc without PAH. Late scleroderma pattern was diagnosed in 30 patients with SSc-PAH and in 27 patients with SSc without PAH. In 3 patients with SSc without PAH, the changes were regarded as nonspecific, in 1 patient signs of RP were revealed. In addition to RP, the development of digital ulcers was noted with the same frequency in the anamnesis (in 25 patients with SSc-PAH and 32 with SSc without PAH). Ischemia in 2 patients with SSc-PAH and in 5 patients with SSc without PAH, amputation in 1 of each group, gangrene in 2 patients only in the group of SSc without PAH.
Conclusion: In the course of the study, it was not possible to identify differences between the severity of capillaroscopic changes, the frequency and severity of digital ischemic disorders in the compared groups. That does not allow using the method of nailfold capillaroscopy as an early diagnosis of PAH in SSc, as well as predicting the development of digital ischemic disorders.
Disclosures: None declared
