Nailfold video capillaroscopy as a useful diagnostic tool in systemic vasculitis

Microvasc Res. 2022 Sep:143:104406. doi: 10.1016/j.mvr.2022.104406. Epub 2022 Jul 11.

Abstract

Background: Nailfold video capillaroscopy (NVC) enables us a direct view of the microvasculature. Only several capillaroscopy studies in adult patients with vasculitis have been reported.

Aim: To characterize NVC changes in vasculitis.

Methods: Vasculitis patients and healthy controls were evaluated by NVC. NVC changes associated with vasculitis were assessed retrospectively in a cohort of 100 patients with Raynaud's phenomenon (RP).

Results: 17 patients with active vasculitis and 8 patients with vasculitis in remission were compared to 25 age and sex-matched healthy controls. Active vasculitis patients demonstrated higher rates of neoangiogenesis and capillary loss in comparison to other groups. Two novel NVC abnormalities were observed in patients with vasculitis: "Rolling" (slow capillary flow) and "peri-capillary stippling" (PCS), small deposits that may represent capillary leak. PCS was observed exclusively in 5 of 17 patients with active vasculitis. Retrospectively, we were able to detect PCS also in 14 % of 100 patients that were evaluated for RP, of whom 64 % were diagnosed with scleroderma or a related disorder.

Conclusions: Patients with active vasculitis demonstrate frequent capillary abnormalities. Although these abnormalities are non-specific, we suggest that their combination may aid the diagnosis of vasculitis. Future studies are needed to validate our findings.

Keywords: ANCA; Nailfold video capillaroscopy; Peri-capillary stippling; Polyarteritis nodosa; Rolling; Systemic sclerosis; Takayasu; Vasculitis.

MeSH terms

  • Adult
  • Capillaries
  • Humans
  • Microscopic Angioscopy
  • Nails / blood supply
  • Raynaud Disease* / diagnosis
  • Retrospective Studies
  • Scleroderma, Systemic*
  • Systemic Vasculitis*
  • Vasculitis*