scholarly journals Nailfold Capillaroscopy in Rheumatic Diseases

2020 ◽  
Author(s):  
Abhishek Patil ◽  
Isha Sood
Keyword(s):  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Early Diagnosis ◽  
Rheumatic Diseases ◽  
Connective Tissue Diseases ◽  
Nailfold Capillaroscopy ◽  
Indispensable Tool

Nailfold capillaroscopy (NFC) has developed into an indispensable tool for rheumatologists in the evaluation of rheumatic diseases. It offers various advantages in being rapid, noninvasive, and inexpensive. With NFC we are able to visualize the microcirculatory changes in the nail beds. These changes are key to the pathogenesis of connective tissue diseases such as systemic sclerosis. Hence NFC helps in early diagnosis of various connective tissue diseases. There is a lack of standardization in the techniques used and various capillary parameters studied, which could lead to variation in the reporting of the parameters studied. In this chapter we shall try to highlight the most common parameters studied in capillaroscopy and its utility in various connective tissue diseases.

THE IMPORTANCE OF ANTIPHOSPHOLIPID SYNDROME IN DEVELOPED CEREBROVASCULAR DISEASES ON THE BACKGROUND OF SYSTEMATIC CONNECTIVE TISSUE DISEASES

2021 ◽  
Vol 2 (1) ◽  
pp. 9-13
Author(s):  
O. Ya. Bustanov ◽  
◽  
Yu. N. Madjidova ◽  
N. A. Nasirdinova ◽  
O. B. Kuchkarova ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Early Diagnosis ◽  
Antiphospholipid Syndrome ◽  
Rheumatic Diseases ◽  
Cerebrovascular Disorders ◽  
Connective Tissue Diseases ◽  
Modern Medicine ◽  
Cerebrovascular Diseases ◽  
Diagnostic Methods

The article developed criteria for early diagnosis of cerebrovascular disorders, one of the complications of antiphospholipid syndrome in patients with systemic connective tissue, and proposed diagnostic methods to prevent this process’s exacerbationand developsevere irreversible complications. This will help stop the development of antiphospholipid syndrome from the urgent problems of modern medicine and manage the effectiveness of treatmentand improve patients’quality of life.Keywords:cerebrovascular pathology, rheumatic diseases, antiphospholipid syndrome, anticardiolipid antibodies

IMMUNOLOGICAL DIAGNOSTICS SYSTEMIC CONNECTIVE TISSUE DISEASES

2020 ◽  
Vol 6 (2) ◽  
pp. 25-39
Author(s):  
O. Borisova
Keyword(s):  
Connective Tissue ◽  
Early Diagnosis ◽  
Rheumatic Diseases ◽  
Clinical Immunology ◽  
Connective Tissue Diseases ◽  
Treatment Method ◽  
Optimal Choice ◽  
Immunological Methods ◽  
Laboratory Diagnostics ◽  
Objective Information

Modern clinical immunology makes it possible to conduct fairly effective laboratory diagnostics of immuno-inflam-matory rheumatic diseases (IVRS). The applied methods make it possible to obtain objective information about the nature of immunopathological changes, being an important tool for diagnosis, assessment of activity, determining the prognosis, choosing a treatment method for the disease and monitoring the effectiveness of therapy. Currently, the optimal choice and use of immunological methods is possible. The main goal of laboratory diagnostics of IVRS is to obtain objective information about the presence and nature of immunopathological changes in the examined patient, which is an important tool for early diagnosis, assessment of activity, severity of the course, prognosis of the disease and the effectiveness of therapy.

Nailfold capillaroscopy microscopy - an interdisciplinary appraisal

VASA ◽  
2016 ◽  
Vol 45 (5) ◽  
pp. 353-364 ◽  
Author(s):  
Peter Franz Klein-Weigel ◽  
Cord Sunderkötter ◽  
Oliver Sander
Keyword(s):  
Differential Diagnosis ◽  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Critical Appraisal ◽  
Connective Tissue Diseases ◽  
Diagnostic Value ◽  
Nailfold Capillaroscopy ◽  
Technical Aspects ◽  
Technical Performance ◽  
Disease Specific

Abstract. Nailfold capillaroscopy is a method of great diagnostic value in the differential diagnosis of primary versus secondary Raynaud´s phenomenon, of systemic sclerosis versus other so called connective tissue diseases and of additional diagnostic value in other entities. Rheumatologists, dermatologists, and angiologists in Germany have convened in an interdisciplinary working group in which they synergistically combined their expertise to develop a common nomenclature and standards for the technical performance of nailfold capillary microscopy. The article gives an overview of historical and technical aspects of capillaroscopy, morphologic findings, and disease-specific patterns. It also provides a critical appraisal of its significance in the diagnosis and sequelae of these interdisciplinarily-managed diseases including its performance in children and gives an excursion in the potential perspectives of capillaroscopy in less common indications.

scholarly journals Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated?

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Mahnaz Etehad Tavakol ◽  
Alimohammad Fatemi ◽  
Abdolamir Karbalaie ◽  
Zahra Emrani ◽  
Björn-Erik Erlandsson
Keyword(s):  
Differential Diagnosis ◽  
Systemic Sclerosis ◽  
Early Diagnosis ◽  
Rheumatic Diseases ◽  
Raynaud’S Phenomenon ◽  
Nailfold Capillaroscopy ◽  
Classification Criterion ◽  
Clinical Practices ◽  
Main Indication ◽  
Monitoring Therapy

Video nailfold capillaroscopy (NFC), considered as an extension of the widefield technique, allows a more accurate measuring and storing of capillary data and a better defining, analyzing, and quantifying of capillary abnormalities. Capillaroscopic study is often performed on the patients suspected of having microcirculation problems such as Raynaud’s phenomenon as the main indication for nailfold capillaroscopy. Capillaroscopic findings based on microcirculation studies can provide useful information in the fields of pathophysiology, differential diagnosis, and monitoring therapy. Nailfold capillaroscopy provides a vital assessment in clinical practices and research; for example, its reputation in the early diagnosis of systemic sclerosis is well established and it is also used as a classification criterion in this regard. This review focuses on the manner of performing video nailfold capillaroscopy and on a common approach for measuring capillary dimensions in fingers and toes.

scholarly journals AB0461 “SCLERODERMA-LIKE” PATTERN AS A PRESENTING FEATURE OF CONNECTIVE TISSUE DISEASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1257.1-1257
Author(s):  
S. Lambova
Keyword(s):  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Rheumatic Diseases ◽  
Clinical Presentation ◽  
Connective Tissue Diseases ◽  
Final Conclusion ◽  
Pathological Feature ◽  
Microvascular Pathology

Background:The role of capillaroscopy for early diagnosis of systemic sclerosis (SSc) is well-known and pathological capillaroscopic pattern is a component of the new set of criteria for SSc (EULAR/ACR 2013). While it is also known that similar microvascular changes i.e., “scleroderma-like” could be observed in other rheumatic diseases i.e., undifferentiated connective tissue disease (UCTD), overlap syndromes, systemic lupus erythematosus (SLE), etc., the data about the time of their appearance in other rheumatic diseases different from SSc are scarce.Objectives:The aim of the study was to evaluate the prevalence of capillaroscopic features of microangiopathy in Raynaud’s phenomenon (RP) patients at the time of their first referral to rheumatology setting.Methods:22 in- and outpatients were included in the study that were referred for consultation in our rheumatology unit in the last 6 months. Inclusion criteria were presence of RP at their first consultation or still unclear diagnosis. Presence of known rheumatic disease diagnosed at previous consultation with rheumatologist as well as signs of definite diagnosis SSc were exclusion criteria. All the patients underwent capillaroscopic examination with USB capillaroscope Dinolite (magnification 200x). Routine laboratory tests were ordered i.e., complete blood count, ESR, CRP, biochemistry as well as immunological tests. ANA test was performed in all patients while antibodies against extractable nuclear antigens, antiphospholipid antibodies or other tests were ordered depending on the clinical presentation and overall context. The patients signed an informed consent for participation of the study.Results:12 of the examined patients were diagnosed with primary RP and their capillaroscopic examination revealed absence of microangiopathy i.e., normal pattern or non-specific changes (mainly dilated capillaries). In 7 patients the final diagnosis was UCTD and 4 of them exhibited microvascular pathology i.e. “scleroderma-like” pattern, while in 3 cases the capillaroscopic findings were non-specific. Among other patients 1 case was diagnosed with prescleroderma with “early” phase “scleroderma” pattern (according to definition of Cutolo et al., 2000 (1)), 1 case was with onset of SLE (“scleroderma-like” pattern, active phase) and in one case the microvascular pathology that included single giant capillary loop no other signs of connective tissue disease were found and the final conclusion was “suspected secondary” RP with necessity for a regular follow-up.Conclusion:In conclusion, definite features of microvascular pathology, known as “scleroderma-like” capillaroscopic pattern, could be observed as an initial pathological feature in CTD different from SSc such as UCTD and SLE and the overall diagnosis should be made in the overall context. Capillaroscopy inherits high significance in patients with UCTD, in whom clinical presentation could be obscure in the beginning and identification of microvascular capillaroscopic pathology is among the crucial signs to support the diagnosis. Future studies are necessary to delineate the role of microvascular pathology for prediction of future evolution of UCTD.References:[1]Cutolo M, Sulli A, Pizzorni C AS. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol. 2000;27(1):155–60.Disclosure of Interests:None declared.

scholarly journals Nailfold Capillaroscopy in Systemic Diseases: Short Overview for Internal Medicine

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Alina Dima ◽  
Ioana Berza ◽  
Daniela Nicoleta Popescu ◽  
Magda Ileana Parvu
Keyword(s):  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Nailfold Capillaroscopy ◽  
Raynaud Phenomenon ◽  
Non Invasive ◽  
Invasive Method ◽  
Spectrum Disorders ◽  
Parallel Fashion

Abstract Nailfold capillaroscopy (NFC) is now one of the main imaging tools in systemic sclerosis and imposed over time as an easy, non-invasive method for the nailfold microvascular bed assessment. In qualitative NFC normal pattern is characterized by homogeneous, parallel fashion arrangement of the last capillaries row as well as by capillaries with hairpin or non-specific variations like tortuous and/ or crossing shape. Nailfold capillaroscopy is strongly recommended for evaluation of all patients with Raynaud phenomenon. Appearance of giant capillaries is chronologically the first finding relevant for scleroderma spectrum disorders development (systemic sclerosis, dermatomyositis, undifferentiated and mixed connective tissue disease). Collapses of the giant loops generate microhemorrhages and further capillary loss with subsequent hypoxia, and neoangiogenesis seen as ramified/ bushy capillaries. Nailfold capillaroscopy is indicated especially in systemic sclerosis, being also included in the classification criteria. Based on these major NFC pathologic findings (giant capillaries, microhemorrhages, avascularity and neoangiogenesis), three evolutive stages were described in systemic sclerosis, namely the early, active, and late scleroderma pattern. In other connective tissue diseases than those scleroderma-related, like systemic lupus erythematosus, psoriatic arthritis, or antiphospholipid syndrome, the interest for capillaroscopy is growing, but the attempts of defining specific characteristics failed until now. Besides qualitative NFC, semiquantitative and quantitative capillaroscopic assessments were proposed for more accurate evaluation. Lately, automated systems are under development. There is still need of more studies to sustain the nailfold capillaroscopy validity as diagnostic and prognostic test.

scholarly journals AB0605 CLINICAL PROFILE AND CHEST HIGH-RESOLUTION COMPUTED TOMOGRAPHY (HRCT) FINDINGS IN PATIENTS WITH CONNECTIVE TISSUE DISEASES AND INTERSTITIAL LUNG DISEASE: EXPERIENCE OF A SINGLE REFERENCE RHEUMATOLOGY CENTER

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1598.2-1599
Author(s):  
I. Rusu ◽  
L. Muntean ◽  
M. M. Tamas ◽  
I. Felea ◽  
L. Damian ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Connective Tissue Diseases ◽  
High Resolution Computed Tomography ◽  
Hrct Patterns

Background:Interstitial lung disease (ILD) is a common manifestation of connective tissue diseases (CTDs), and is associated with significant morbidity and mortality. Chest high-resolution computed tomography (HRCT) play an important role in the diagnosis of ILD and may provide prognostic information.Objectives:We aimed to characterize the clinical profile and chest HRCT abnormalities and patterns of patients diagnosed with CTDs and ILD.Methods:In this retrospective, observational study we included 80 consecutive patients with CTDs and ILD referred to a tertiary rheumatology center between 2015 and 2019. From hospital charts we collected clinical data, immunologic profile, chest HRCT findings. HRCT patterns were defined according to new international recommendations.Results:Out of 80 patients, 64 (80%) were women, with a mean age of 55 years old. The most common CTD associated with ILD was systemic sclerosis (38.8%), followed by polymyositis (22.5%) and rheumatoid arthritis (18.8%). The majority of patients had dyspnea on exertion (71.3%), bibasilar inspiratory crackles were present in 56.3% patients and 10% had clubbing fingers. Antinuclear antibodies (ANA) were present in 78.8% patients, and the most frequently detected autoantibodies against extractable nuclear antigen were anti-Scl 70 (28.8%), followed by anti-SSA (anti-Ro, 17.5%), anti-Ro52 (11.3%) and anti-Jo (7.5%). Intravenous cyclophosphamide therapy for 6-12 months was used in 35% of patients, while 5% of patients were treated with mycophenolate mofetil.The most frequent HRCT abnormalities were reticular abnormalities and ground glass opacity. Non-specific interstitial pneumonia (NSIP) was identified in 46.3% CTDs patients. A pattern suggestive of usual interstitial pneumonia (UIP) was present in 32.5% patients, mainly in patients with systemic sclerosis. In 21.3% patients the HRCT showed reticulo-nodular pattern, micronodules and other abnormalities, not diagnostic for UIP or NSIP pattern.Conclusion:Nonspecific interstitial pneumonia (NSIP) is the most common HRCT pattern associated with CTDs. Further prospective longitudinal studies are needed in order to determine the clinical and prognostic significance of various HRCT patterns encountered in CTD-associated ILD and for better patient management.References:[1]Ohno Y, Koyama H, Yoshikaua T, Seki S. State-of-the-Art Imaging of the Lung for Connective Tissue Disease (CTD). Curr Rheumatol Rep. 2015;17(12):69.[2]Walsh SLF, Devaraj A, Enghelmeyer JI, Kishi K, Silva RS, Patel N, et al. Role of imaging in progressive-fibrosing interstitial lung diseases. Eur Respir Rev. 2018;27(150)Disclosure of Interests:None declared

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