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Nailfold capillary abnormalities in patients with familial Mediterranean fever
A Dinç1, M Melikoğlu, C Korkmaz
1Division of Rheumatology, Department of Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Turkey.
Objective:
To determine the frequency and the degree of the nailfold capillary abnormalities in patients with familial Mediterranean fever (FMF).
Methods:
We studied 67 (M/F: 28/39) patients with FMF. Thirty-seven healthy subjects (16/21), 19 patients (0/19) with systemic lupus erythematosus (SLE), and 8 patients (0/8) with scleroderma (PSS) were also studied. All participants were questioned for the presence of Raynaud's phenomenon (RP). Capillary loops of eight fingers were evaluated and scored with respect to avascular areas, tortuosity, enlargement and extravasations by the conventional capillary microscopy. Both FMF patients and healthy controls were examined in a blind manner.
Results:
FMF patients differed from healthy controls by the presence of increased tortuosity and enlargement of capillary loops, but not by microhemorrhages. Being female and the presence of RP were the factors that correlated with the capillaroscopic findings.
Conclusion:
Capillary abnormalities are seen in patients with FMF.
Insights
Nailfold capillary abnormalities, including increased loop tortuosity and enlargement, are present in patients with familial Mediterranean fever (FMF). These findings correlate with female sex and Raynaud
Area of Science:
- Rheumatology
- Vascular Biology
- Genetics
Background:
- Familial Mediterranean fever (FMF) is a genetic autoinflammatory disorder.
- Microvascular changes may contribute to FMF pathophysiology.
- Nailfold capillaroscopy is a non-invasive method to assess microcirculation.
Purpose of the Study:
- To quantify the frequency and severity of nailfold capillary abnormalities in FMF patients.
- To compare capillaroscopic findings in FMF patients with healthy controls and other rheumatic diseases.
- To identify factors associated with capillaroscopic changes in FMF.
Main Methods:
- Conventional capillaroscopy was used to evaluate nailfold capillaries in 67 FMF patients, 37 healthy controls, 19 SLE patients, and 8 PSS patients.
- Capillary loops were assessed for avascular areas, tortuosity, enlargement, and extravasations.
- Participants were surveyed for Raynaud's phenomenon (RP), and FMF patients and controls underwent blind examination.
Main Results:
- FMF patients exhibited significantly increased capillary loop tortuosity and enlargement compared to healthy controls.
- No significant difference in microhemorrhages was observed between FMF patients and controls.
- Female sex and the presence of Raynaud's phenomenon were correlated with capillaroscopic abnormalities in FMF.
Conclusions:
- Nailfold capillaroscopy reveals characteristic capillary abnormalities in patients with familial Mediterranean fever.
- These microvascular changes may be relevant to the clinical manifestations of FMF.
- Further research is warranted to elucidate the role of these abnormalities in FMF.