Related Experiment Video
Updated: Jan 12, 2026
Non-Invasive Visualization of Nailbed Microvascular Morphology in Mice Using Capillaroscopy
Published on: February 28, 2025
Microvascular changes in children with MIS-C: a monocentric exploratory study using comparative nailfold
Sema Nur Taşkın1, Şeyda Doğantan1, Esra Esen1
1Division of Pediatric Rheumatology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Türkiye.
Insights
Nailfold capillaroscopy revealed significant microvascular changes in children with Multisystem Inflammatory Syndrome (MIS-C), including increased tortuosity and dilated capillaries. This non-invasive technique aids in detecting early microvascular issues in MIS-C patients.
Area of Science:
- Pediatric rheumatology
- Vascular biology
- Infectious diseases
Background:
- Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe post-SARS-CoV-2 hyperinflammatory condition.
- MIS-C can cause endothelial dysfunction and microvascular damage, but microcirculatory involvement is understudied.
Purpose of the Study:
- To assess nailfold capillaroscopy (NFC) findings in children with MIS-C.
- To compare NFC results between MIS-C patients and healthy controls.
- To identify subclinical microvascular alterations in MIS-C.
Main Methods:
- A cross-sectional study involving 25 MIS-C patients and 29 age-/sex-matched controls.
- Standardized nailfold capillaroscopy (NFC) performed by a blinded examiner.
- Analysis of morphological and quantitative capillary parameters, including tortuosity, crossing, and dilatation.
Main Results:
- MIS-C patients showed significantly higher rates of capillary tortuosity (92.0% vs. 62.1%) and crossing (64.0% vs. 27.6%).
- Dilated capillaries (16.0% vs. 0%) and increased disorganization scores were observed in MIS-C patients.
- Reduced apical loop width (12 vs. 14 µm) was noted in the MIS-C group.
Conclusions:
- Nailfold capillaroscopy reveals significant microvascular alterations in pediatric MIS-C.
- NFC is a valuable non-invasive tool for assessing endothelial dysfunction and microvascular involvement in MIS-C.
- This study provides crucial data on microvascular changes in MIS-C, establishing a reference for future research.
Background:
Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe hyperinflammatory condition that arises after SARS-CoV-2 infection and may lead to endothelial dysfunction and microvascular damage. Despite increasing knowledge on systemic manifestations, microcirculatory involvement in MIS-C remains underexplored.
Objective:
To evaluate nailfold capillaroscopy (NFC) findings in children diagnosed with MIS-C and compare them with age- and sex-matched healthy controls, thereby assessing subclinical microvascular alterations associated with MIS-C.
Methods:
In this cross-sectional study, 25 MIS-C patients meeting CDC criteria and 29 age-/sex-matched controls underwent standardized NFC at 200× magnification by a blinded examiner. Eight fingers (excluding thumbs) were imaged. Morphological parameters (tortuosity, crossing, dilatation, neoangiogenesis, etc.) and quantitative measures (capillary density, lengths, widths, intercapillary distance) were recorded. Tortuosity and crossing were scored semi-quantitatively (0: absent; 1: < 50% affected; 2: > 50% affected). Between-group comparisons used Mann-Whitney U and Chi-square/Fisher tests (α = 0.05).
Results:
MIS-C patients had higher rates of tortuosity (92.0% vs. 62.1%, p = 0.010), crossing (64.0% vs. 27.6%, p = 0.007) and dilated capillaries (16.0% vs. 0%, p = 0.040). Apical loop width was reduced (median 12 vs. 14 µm, p < 0.001) and disorganization score increased (p = 0.020). Semi-quantitative scores were higher for tortuosity (p = 0.002), crossing (p = 0.003) and dilatation (p = 0.027) in MIS-C. No meandering, giant capillaries, avascular areas or microhemorrhages were observed.
Conclusion:
Nailfold capillaroscopy revealed notable microvascular alterations in children with MIS-C, including increased tortuosity, dilated capillaries, and disorganization. These findings suggest that NFC may serve as a useful non-invasive tool for detecting endothelial dysfunction and early microvascular involvement in MIS-C. Importantly, given the current rarity of MIS-C cases in the post-pandemic era, this study provides a unique and timely contribution, offering one of the few systematic evaluations of microvascular alterations in pediatric MIS-C and establishing a valuable reference point for future comparative research in pediatric vasculopathies.
