Nailfold capillaroscopy in inflammatory bowel disease: A shared approach in gastroenterology and rheumatology

Inflammatory bowel disease (IBD) has systemic consequences that extend beyond the gastrointestinal tract. While nailfold capillaroscopy (NFC) is widely utilized in many rheumatological disorders, its significance in evaluating microvascular changes in IBD remains unknown. This study aimed to standardize NFC use in IBD patients and relate NFC results to clinical and laboratory criteria.

This observational case-control study included histology- and colonoscopy-diagnosed IBD patients. We performed NFC on eight fingers of each subject using a Dino-Lite digital microscope, adhering to European Alliance of Associations for Rheumatology guidelines. Capillary characteristics, including density, morphology, and dimensions, as well as microhemorrhages, were assessed at 200×.

The study included 50 IBD patients and 30 healthy controls. IBD patients had significantly lower capillary density (7.52±0.68capillaries/mm) than controls (8.18±0.63capillaries/mm, p<0.001), with 26% of IBD patients exhibiting densities below seven capillaries/mm. In IBD patients, microhemorrhages were more prevalent than in controls (p=0.032). Raynaud's phenomenon was more commonly detected in patients with low mean capillary density (p=0.04).

IBD patients had reduced mean capillary density and increased microhemorrhages. These changes suggested that NFC could be a non-invasive way provides unique insights into IBD microvascular health. .