Abstract

SILVA, Juliana et al. Nailfold Capillaroscopy in the Evaluation of Autoimmune Diseases. Medicina Interna [online]. 2017, vol.24, n.4, pp.285-289. ISSN 0872-671X.  https://doi.org/10.24950/rspmi/O37/17/2017.

Introduction:Nailfold capillaroscopy is a simple, safe and noninvasive method, essential in the evaluation of the microcirculation in vivo, and crucial to distinguish between primary or secondary Raynaud’s phenomenon. Raynaud’s phenomenon assumes its major importance in the spectrum of systemic sclerosis diseases showing the early involvement and the vascular changes in the microcirculation before the onset of other clinical symptoms or organ involvement, and creating an opportunity to prevent vascular complications. Methods:We analyzed, retrospectively, clinical data and results of nailfold capillaroscopy from 110 patients followed up at an autoimmune disease consultation, mainly female. Results:The main reason for performing Nailfold capillaroscopy was the study of Raynaud’s phenomenon, mainly secondary cases (67.4%), being the most frequent underlying pathology the systemic sclerosis. Significant changes were not found in the capillaries architecture in 27.3% (n = 30). In the remaining, we found minor changes in 28 cases, presence of megacapillaries in 41 patients (37.3%), avascular areas in 35 (37.8%), microhemorrhages in 36 patients (32.7%) and signs of neoangiogenesis in five (4.5%). The majority of systemic sclerosis patients have secondary Raynaud’s. Only two patients with systemic sclerosis did not have a well-defined scleroderma pattern in the nailfold capillaroscopy. Conclusion: The nailfold capillaroscopy effectiveness on early diagnosis of systemic sclerosis, on monitoring disease progression and in the prediction of organ involvement, making it an essential noninvasive method, as supported by its inclusion in the systemic sclerosis classification criteria.

Keywords : Autoimmune Diseases; Capillaries; Microscopic Angioscopy; Nails/blood supply; Raynaud Disease; Scleroderma, Systemic.

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