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Nailfold capillary microscopy in adults with inflammatory myopathy
Albert Selva-O'Callaghan1, Vicente Fonollosa-Pla, Ernesto Trallero-Araguás
1Internal Medicine Department, Vall d'Hebron General Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain. aselva@vhebron.net
Seminars in Arthritis and Rheumatism
|November 22, 2008
Summary
Nailfold capillaroscopy reveals significant changes in inflammatory myopathies, correlating with disease activity and severity. This simple method aids early diagnosis and prognosis in idiopathic inflammatory myopathy patients.
Area of Science:
- Rheumatology
- Dermatology
- Internal Medicine
Background:
- Idiopathic inflammatory myopathies (IIMs) are a group of rare autoimmune diseases affecting muscles.
- Nailfold capillaroscopy is a non-invasive technique to visualize microcirculation.
- Understanding nailfold capillary changes in IIMs can provide insights into disease pathogenesis and progression.
Purpose of the Study:
- To investigate nailfold capillary alterations in adult patients with inflammatory myopathies.
- To correlate these changes with disease activity, severity, and clinical/immunological characteristics.
- To assess the utility of capillaroscopy in diagnosing and predicting prognosis in IIMs.
Main Methods:
- Fifty-three adult patients with inflammatory myopathies were evaluated using stereomicroscopy.
- A semiquantitative scale assessed capillaroscopy changes.
- Disease activity and severity were measured using validated tools (MDAAT and MDI).
- Statistical analyses (chi(2), Mann-Whitney U) explored associations with clinical and serological data.
Main Results:
- 43% of patients exhibited relevant capillaroscopy changes.
- Increased capillaroscopy findings significantly correlated with higher disease activity and severity.
- Specific patterns were associated with dermatomyositis and paraneoplastic myositis.
- Interstitial lung disease showed a correlation with elevated capillary scores.
Conclusions:
- Simple, semiquantitative nailfold capillaroscopy offers valuable diagnostic and prognostic information in idiopathic inflammatory myopathy.
- It aids in early diagnosis and identifies patients with potentially poorer outcomes.
- Capillary findings contribute to a comprehensive assessment of IIM patients.
