Date: Monday, November 6, 2017
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Connective tissue diseases (CTD) patients have various clinical manifestation including pulmonary hypertension (PH) and digital ulcer (DU). Especially, Raynaud’s phenomenon (RP) is one of the common symptoms. On the other hand, “abnormal nailfold capillaries” are important as the findings that suggest RP associated with CTD. They are included in one of the items of classification criteria for Sclerderma (SSc) in 2013 Classification Criteria for Systemic Sclerosis（ACR/EULAR). Recently, some reports presented the usefulness of nailfold capillaroscopy (NFC) in SSc. NFC findings showed enlarged/giant capillaries, fresh or old haemorrhages, avascular areas, ramified/bushy capillaries. These findings are known as “scleroderma pattern” features. Additionally, there are some reports that nailfold capillary low density in SSc related with merger of DU, PH and interstitial pneumonia (IP).
In this study, we clarify the association between nailfold capillary density and clinical manifestation by analysis of the case in our institution.
We enrolled Japanese CTD patients including SSc, Systemic Lupus erythematosus (SLE), Mixed Connective Tissue Disease (MCTD), Sjögren’s syndrome (SS), Dermatomyositis (DM) from May 2016 to May 2017 in our institution.
We measured total nailfold capillary count per 1µm from second to fifth finger by NFC “OptiPiX Capillaroscopy Clinic 1.7.x”. In addition, we investigated relationship with NFC findings and clnical manifestation (or laboratory data) such as current and previous DU, RP, PH and IP.
We enrolled 107 CTD patients (100 females, 7 males; 42 SSc, 25 SLE, 16 PM/DM, 9 MCTD, 16 SS). Total nailfold capillary counts significantly decreased in all CTD patients with current DU (ρ= -0.4333, p = 0.0003), previous DU (ρ= -0.4202, p = 0.0004), RP (ρ= -0.3350, p = 0.006) and PH (ρ= -0.3683, p = 0.0023). In addition, Total nailfold capillary counts associated with current DU (ρ= -0.3855, p = 0.0477) and previous DU (ρ= -0.4481, p = 0.0191) in SSc patients and PH (ρ= -0.8281, p = 0.0418) in MCTD patients. There is no significant difference between “scleroderma pattern” features and clinical manifestation.
Our study revealed that total nailfold capillary counts were associated with clinical manifestation in CTD patients. We suggest that nailfold capillary density may predict clinical manifestation with CTD patients.
To cite this abstract in AMA style:Kondo A, Kameda T, Izumikawa M, Shimada H, Nakashima S, Wakiya R, Kato M, Kadowaki N, Dobashi H. Nailfold Capillary Counts Are Associated with Clinical Manifestations in Connective Tissue Disease Japanese Patitents [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/nailfold-capillary-counts-are-associated-with-clinical-manifestations-in-connective-tissue-disease-japanese-patitents/. Accessed September 26, 2021.
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