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Nailfold Videocapillaroscopy May Aid in Early Diagnosis of Systemic Sclerosis
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MADRID — Nailfold videocapillaroscopy demonstrated feasibility as a diagnostic tool for systemic sclerosis, particularly among patients with Raynaud’s phenomenon, according to findings presented at the Annual European Congress of Rheumatology.
“As there is no real treatment for overt systemic sclerosis, the systemic sclerosis community is interested [in being able] to detect the early disease signals to optimize management,” Vanessa Smith, MD, of the Department of Internal Medicine at the University of Ghent and the Department of Rheumatology at Ghent University Hospital in Belgium, said in a press conference.
“Nailfold videocapillaroscopy is a safe, noninvasive tool to evaluate morphologic changes in microcirculations,” she said. “It is a microscope with a tiny video camera attached to it.”
Smith and colleagues studied 1,085 patients from 40 centers. Patients were categorized in terms of antinuclear antibody status (positive or negative), clinical symptoms, capillaroscopic changes, systemic sclerosis-specific autoantibodies and controls.
Results indicated nailfold videocapillaroscopic patterns were present in 79% of patients with early disease, in 13% of patients with active disease, in 0% of patients with late disease and in 8% of scleroderma-like patients.
These patterns were observed in 49% of antinuclear antibody-positive patients compared with 15% of those who were antinuclear antibody negative.
Video results also showed moderate or extensive giant capillaries were present in 49% of the cohort, while hemorrhages were observed in 32%, and both capillary loss and abnormal shapes were found in 11%. These outcomes occurred in 0% of controls.
Quantitative capillaroscopic analysis results indicated moderate or extensive giant capillaries were found in 23% of antinuclear antibody-positive patients and in 5% of negative patients. No statistically significant differences were reported for hemorrhages, capillary loss or abnormal shapes between the positive and negative groups.
“The performance of nailfold videocapillaroscopy is feasible in diagnostic centers for the early detection of systemic sclerosis,” Smith said. “In the Raynaud’s phenomenon cohort, nailfold videocapillaroscopy plays a pivotal role as an early biomarker for diagnosis.” — by Rob Volansky
Reference:
Cutolo M, et al. Abstract #OP0035. Presented at: EULAR Annual Congress; June 14-17, 2017; Madrid.
Disclosure: The researchers report no relevant financial disclosures.