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Abstract Number: 786

Comparison of Nailfold Microvascular Damage in Mixed Connective Tissue Disease Versus Systemic Sclerosis Patients during a Three Year Follow-up

Alberto Sulli1, Giorgia Ferrari1, Carmen Pizzorni1, Barbara Ruaro1, Sabrina Paolino2, Vanessa Smith3 and Maurizio Cutolo1, 1Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, San Martino Polyclinic Hospital, Genoa, Italy, Genoa, Italy, 2Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, San Martino Polyclinic Hospital, Genoa, Italy, Genova, Italy, 3Department of Internal Medicine, Department of Rheumatology, Ghent University Hospital, Department of Internal Medicine, Ghent University, Ghent, Belgium, Ghent, Belgium

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Capillaroscopy, mixed connective tissue disease (MCTD) and systemic sclerosis

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Session Information

Date: Sunday, October 21, 2018

Session Title: Systemic Sclerosis and Related Disorders – Clinical Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: In systemic sclerosis (SSc), capillary abnormalities progress in a clearly defined sequence called the “scleroderma patterns” (Early, Active, Late) (1-3). On the contrary, characteristic nailfold capillary abnormalities are not present in mixed connective tissue disease (MCTD) (1,2). Until today, few studies described the main nailfold videocapillaroscopy (NVC) changes in MCTD (4,5). The aim of this retrospective study was to compare nailfold capillary abnormalities in MCTD and SSc patients at first NVC visit, and to monitor MCTD capillary changes over a three year follow-up.

Methods: Ten patients (mean age 50±19 years, mean disease duration 6.4±4.2 years) affected by MCTD (Kasukawa’s criteria) who performed their first NVC were enrolled. Main capillary parameters (scores of capillary ramifications, enlarged capillaries, giant capillaries, microhemorrhages, number of capillaries, as well as absolute number of normal and total capillaries per linear millimetre) were evaluated in MCTD patients by NVC at baseline (T0, first NVC), and during a three year follow-up. Furthermore, NVC parameters were compared at T0 with 10 random SSc patients with the same disease duration (6.4±4.2 years) and similar age (51±17 years). Statistical analysis was performed by non parametric tests. The patients were receiving different immunosuppressive treatments.

Results: The scores of enlarged capillaries, giant capillaries and microhemorrhages were found significantly higher in patients with SSc versus MCTD patients at T0 (2.50±0.5 vs 1.90±0.6 p=0.04, and 1.63±0.7 vs 0.70±0.7 p<0.02, 1.25±0.7 vs 0.70±0.7 p=0.05, respectively). Moreover, the absolute number of total capillaries and normal capillaries were found significantly lower in SSc patients versus MCTD patients (5.8±1.9 vs 7.6±1.6 p=0.04 and 0.45±1.0 vs 3.03±2.9 p= 0.009). On the contrary, no statistically significant difference was observed for the other capillary parameters (including capillary ramifications) between the two groups of patients. No statistically significant variation of the scores as well as of the absolute value of the above reported capillary parameters was observed during the 3 years of follow-up in MCTD patients. No statistically significant correlation was observed between capillary parameters and MCTD clinical aspects (Raynaud phenomenon, dysphagia, dyspnoea, sclerodactily, sicca syndrome, teleangectasias and artharlgia) at first visit and during follow-up.

Conclusion: In a limited cohort of MCTD patients with an average disease duration of 6.4 years and a follow-up of three years, the nailfold microangiopathy does not seem to be significantly progressive. Patients with MCTD seem to show less enlarged/giant capillaries, and larger absolute number of total and normal capillaries than SSc patients.

References. 1.Cutolo M. et al. Best Pract Res Clin Rheumatol 2008; 22:1093-108. 2.Cutolo M. et al. J Rheumatol. 2000; 27:155-60. 3.Sulli A et al. Arthritis Rheum. 2012;64:821-5. 4.De Holanda Mafaldo DA, et al. Lupus. 2007; 16:254–8. 5.Cappelli S. et al. Semin Arthritis Rheum. 2012; 41:589-98.


Disclosure: A. Sulli, None; G. Ferrari, None; C. Pizzorni, None; B. Ruaro, None; S. Paolino, None; V. Smith, None; M. Cutolo, None.

To cite this abstract in AMA style:

Sulli A, Ferrari G, Pizzorni C, Ruaro B, Paolino S, Smith V, Cutolo M. Comparison of Nailfold Microvascular Damage in Mixed Connective Tissue Disease Versus Systemic Sclerosis Patients during a Three Year Follow-up [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/comparison-of-nailfold-microvascular-damage-in-mixed-connective-tissue-disease-versus-systemic-sclerosis-patients-during-a-three-year-follow-up/. Accessed May 28, 2023.
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