Clinical aspects
From VEDOSS to established systemic sclerosis diagnosis according to ACR/EULAR 2013 classification criteria: a French-Italian capillaroscopic survey
M. Vasile1, J. Avouac2, I. Sciarra3, K. Stefanantoni4, N. Iannace5, E. Cravotto6, G. Valesini7, Y. Allanore8, V. Riccieri9
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
- Rheumatology A Department, Cochin Hospital, Paris Descartes University, Paris, France.
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
- Rheumatology A Department, Cochin Hospital, Paris Descartes University, Paris, France.
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy. valeria.riccieri@uniroma1.it
CER11205
2018 Vol.36, N°4 ,Suppl.113
PI 0082, PF 0087
Clinical aspects
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PMID: 30183599 [PubMed]
Received: 26/02/2018
Accepted : 07/05/2018
In Press: 29/08/2018
Published: 29/09/2018
Abstract
OBJECTIVES:
Nailfold capillaroscopy (NC) shows microcirculatory abnormalities in systemic sclerosis (SSc). The inclusion of NC specific abnormalities increases the sensitivity of both 2013 ACR/EULAR and VEDOSS (Very Early Diagnosis of Systemic Sclerosis) classification criteria. We aimed to detect NC features able to predict progression toward established SSc in VEDOSS patients.
METHODS:
Sixty-six VEDOSS patients were enrolled. They had a clinical follow-up and underwent NC once a year, considering morphological parameters, appropriate pattern and semi- quantitative rating scale.
RESULTS:
In a mean follow-up time of 31 months, 21 patients progressed into SSc (P = Progressors), while 45 were “Non Progressor” (NP). Comparing NC basal features of both groups, significantly larger loop diameter and apex width, higher haemorrhage and NC scores were found in P respect to NP patients. When comparing NC features of P patients who progressed within one year (FP = Fast progressor), loop diameter and apex width were significantly higher compared to all VEDOSS subjects. Each unit increase of apex width was associated with an increasing risk of 1% for developing SSc and the cut-off value of 103 μm showed a positive predictive value of 56% and a negative predictive value of 71%.
CONCLUSIONS:
We describe NC findings in VEDOSS patients, identifying those suggesting a progression into established disease. These findings must be regarded as possible predictive risk factor to develop SSc and can also be of relevance in the detection of those cases with a faster development. Thus NC seems to have a diagnostic and prognostic role in VEDOSS cases.