Capillaroscopy in the diagnosis of systemic autoimmune disease

Abstract

Introduction: nailfold capillaroscopy (NC) consists of the in vivo observation of capillary microcirculation, which usually presents three patterns (tortuos, sclerodermiform and normal).
Objective: to describe capillary alterations in patients who consulted at the Systemic Autoimmune Diseases Unit of the Clínicas Hospital, between August 2009 and October 2010.
Patients, material and methods: we conducted a descriptive, retrospective and qualitative study of capillaroscopy patterns.
Results: the medical records and NC of 110 patients were reviewed (102 women), average age was 46.6 ± 17.5 years old, being the largest group represented by 34 (31%) patients with systemic sclerosis. Patterns found in the NC were normal in 38% of cases and pathological in 62% of them. Eighty eight per cent of patients with systemic sclerosis presented a pathological NC, and 74% of the latter corresponded to a sclerodermiform pattern. We found a pathololgical pattern in 66% of patients with autoimmune diseases (except for systemic sclerosis), where 27% corresponded to a sclerodermiform pattern.
Conclusions: NC contributed to the study of the Raynaud phenomenon and autoinmune diseases in different ways. Identifying a sclerodermiform pattern highly suggested the presence of a systemic autoimmune disease. The NC, together with clinical findings and the appropriate biological markers gains value and specificity in the diagnosis, and it thus should be a part of the clinical assessment of patients with the Raynaud's disease and a clinical or analytical suspicion of systemic autoimmune disease.