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Changes in cutaneous microcirculation, hemorrheology and platelet aggregation function in dermatomyositis
Abstract:
Marked disturbance of microcirculation was observed in 85 cases of dermatomyositis: decrease in number and irregular pattern of the capillaries, many being tortuous and dilated and having a slow and granular blood stream, as well as an increase of vascular permeability. The changes were more marked in cases with visceral disorders, or in active disease; however, there was no correlation between these changes and the duration of illness. Blood hyperviscosity was found in an hemorrheological study. The cause is considered to be due to high plasma viscosity, high fibrinogen levels, and increase of aggregation of erythrocytes and platelets. Modulation of microcirculation is advisable in the treatment of dermatomyositis.
Insights
Dermatomyositis significantly disrupts microcirculation, affecting capillaries and blood flow. Addressing these vascular changes is crucial for effective treatment of this inflammatory disease.
Area of Science:
- Rheumatology
- Vascular Biology
- Dermatology
Background:
- Dermatomyositis is an idiopathic inflammatory myopathy.
- Microcirculatory disturbances are increasingly recognized in autoimmune diseases.
Purpose of the Study:
- To investigate microcirculatory alterations in dermatomyositis patients.
- To explore the relationship between microcirculatory changes and disease activity.
- To identify hemorrheological factors contributing to these alterations.
Main Methods:
- Observational study of 85 dermatomyositis cases.
- Capillary microscopy to assess microcirculation.
- Hemorrheological analysis including plasma viscosity, fibrinogen, erythrocyte, and platelet aggregation.
Main Results:
- Observed decreased capillary number, irregular patterns, tortuosity, dilation, slow blood flow, and increased vascular permeability.
- Microcirculatory changes were more pronounced in patients with visceral involvement and active disease.
- Blood hyperviscosity was linked to high plasma viscosity, elevated fibrinogen, and increased erythrocyte and platelet aggregation.
- No correlation found between microcirculatory changes and disease duration.
Conclusions:
- Microcirculatory dysfunction is a significant feature of dermatomyositis.
- Hemorrheological abnormalities contribute to impaired blood flow.
- Modulation of microcirculation should be considered in therapeutic strategies for dermatomyositis.