Nailfold Videocapillaroscopy in Healthy Children and Adolescents: Description of Patterns of Normality

Daniela Piotto¹, Juliana Sekiyama², Cristiane Kayser³, Mariana Yamada⁴, Claudio A. Len⁵ and Maria Teresa Terreri⁶, ¹Universidade Federal de São Paulo/UNIFESP, Assistant Doctor, Universidade Federal de São Paulo/UNIFESP, São Paulo, Brazil, ²Universidade Estadual de Campinas, Campinas, Brazil, ³Rheumatology Division, Universidade Federal de São Paulo, São Paulo, Brazil, ⁴Universidade Federal de São Paulo, Pediatric Resident, São Paulo, Brazil, ⁵Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, Brazil, ⁶Universidade Federal de São Paulo/UNIFESP, São Paulo, Brazil

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Health, measure, nailfold capillaroscopy and pediatrics

Session Information

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics: Determinants of Disease, Classification and Response

Session Type: Abstract Submissions (ACR)

Background/Purpose

Video capillaroscopy (VCP) allows for the evaluation of capillary dimensions and to quantify the degree of microangiopathic alterations in autoimmune diseases. However, studies in healthy subjects and specially in children and adolescents are limited. To describe the normal pattern of capillaries by VCP in healthy children and adolescents, and to evaluate the inter and intraobserver concordance in capillary measurements.

Methods

Cross-sectional study of 100 healthy participants aged 5 to18 years by VCP. The capillary dimensions ( capillary loop length, capillary width and inter capillary distance) and the number of capillaries/mm were evaluated under 100x magnification, acquiring three consecutive images of nine capillaries per individual, totaling 900 capillaries examined and photographed. Four age groups were studied: 5-7 years (17 individuals); 8-10 years (24 individuals); 11-14 years (30 individuals) and 15-18 years (29 individuals). The intra and inter observer concordance was tested in 25% of subjects by two professionals with experience in this method.

Results

The capillary dimensions (mean ± SD) were: capillary loop length 278.6 ± 60.3 µm, inter capillary distance 124.1 ± 28.1 µm, capillary width 15.0 ± 2.6 µm and 7.8 ± 1.5 number of capillaries /mm. The only significant difference between males and females was the inter capillary distance which was higher in girls (p = 0.011). When comparing the four age groups, only the intercapillary distance remained constant over time (p=0.088). Teenagers between 15 and 18 years had longer and thicker capillaries (318.7 ± 64.4 µm) and (16.2 ± 3.3 µm) resp. when compared to other age groups (p <0.001 and p = 0.012 respectively). We also found an increase in the number of capillaries/mm with age: 6.1 capillaries/mm (5-7 years); 7.0 (8 to 10 years); 8.0 (11-14 years) and 9.3 (15-18 years) (p <0.001). There was a good intra and interobserver concordance in the analysis of capillary dimensions and the number of capillaries/mm by VCP. In VCP, 11% had enlarged capillary (capillary width percentile> 97.5) and 10% avascular areas (inter capillary distance percentile> 97.5). There was a negative correlation between the distance and the number of capillaries/mm.

Conclusion

This study evaluated the normal pattern of VCP in healthy children and adolescents and stratified patients by age groups. The number of capillaries /mm, the length and thickness of the capillary increased with age, while the intercapillary distance was maintained over the years.

Disclosure:

D. Piotto,
None;

J. Sekiyama,
None;

C. Kayser,
None;

M. Yamada,
None;

C. A. Len,
None;

M. T. Terreri,
None.

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