Background:Nailfold videocapillaroscopy is a non-invasive tool for the assessment of peripheral microcirculation, and it is useful for the diagnosis and prognosis of systemic autoimmune diseases. Despite its frequent use in clinical practice, the indications of this procedure are not standardized and there is no clear information in real-life about the reasons for remission, the presence of clinical findings of autoimmune diseases during the procedure, the frequency of patterns of autoantibodies and specific capillaroscopic findings.Objectives:To describe the sociodemographic, clinical, paraclinical, and capillaroscopic findings of a cohort of subjects referred to a capillaroscopy service in northwestern Colombia.Methods:We conducted a retrospective cohort study, including subjects from 2015 to 2018. Patients were evaluated by two expert rheumatologists. Variables: Reasons for referral, capillaroscopic patterns at baseline and at 6-month follow-up, presence of clinical findings of systemic autoimmune diseases during the procedure (Raynaud´s phenomenon, puffy fingers, sclerodactyly, pitting scars, digital ulcers, sclerosis cutis, platysma sign, Gottron, and microstomy), along with the pattern and dilution of antinuclear antibodies. Categorical variables were expressed in frequency and percentage and quantitative variables in mean and standard deviation or median with interquartile range, depending on the distribution of the data. Statistical package: SPSS 25. This survey was approved by the institutional Ethics Committee.Results:A total of 392 capillaroscopies were performed, 318 for the first time. The referral reasons for capillaroscopy were: Raynaud`s phenomenon (n=134; 42.1%), connective tissue disease different than systemic sclerosis (SSc) (n=105; 33.1%), and systemic sclerosis (n=79; 24.8%). The baseline capillaroscopic patterns found were: Normal (n=123; 38.7%), non-specific (n=81; 25.5%), SSc (n=90; 28.3%), scleroderma-like (n=24; 7.5%). Among SSc pattern, early (21/90; 23.3%), active, (38/90; 42.2%), and late patterns (31/90; 34.4%) were found. Of the 12 capillaroscopies that presented a non-specific pattern at 6-month follow-up, only one (8.3%) progressed to a systemic sclerosis pattern. In the SSc patterns, the frequency of clinical findings were: sclerodactyly (n=34; 37.8%), Raynaud`s phenomenon (n=26; 28.9%), puffy fingers (n=10; 11.1%), platysma sign (n=10; 11.1%), pitting scars (n=8; 8.9%), digital ulcers (n=8; 8.9%), telangiectasia (n=7; 7.8%), microstomy (n=4; 4.4%), and Gottron (n=1; 1.1%). In the SSc patterns, 42/44 subjects (95,4%) had positive antinuclear antibodies in an mean dilution of 1:320; the most frequent patterns were: centromere (n=27; 64.3%) and nucleolar (n=6; 14-3%).Conclusion:In a real-world setting, the main referral reason to a capillaroscopic center was Raynaud`s phenomenon; more than a third of the subjects had normal capillaroscopic findings; in the subgroup of baseline non-specific pattern, most of them were normal during follow-up; sclerodactyly and Raynaud`s phenomenon were the most frequent clinical findings in patients with systemic sclerosis capillaroscopic patterns.References:[1]Melchor S, et al. Semin Arthritis Rheum. 2016; 46(3): 350-5.[2]Fichel F, et al. Dermatology. 2014;228(4): 360-7Acknowledgments:School of Health Sciences. Universidad Pontificia Bolivariana. Clinica Universitaria Bolivariana. Medellin, ColombiaDisclosure of Interests:None declared
Osteonecrosis of carpal bones in systemic sclerosis
