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Clinical aspects

 

From VEDOSS to established systemic sclerosis diagnosis according to ACR/EULAR 2013 classification criteria: a French-Italian capillaroscopic survey


1, 2, 3, 4, 5, 6, 7, 8, 9

 

  1. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
  2. Rheumatology A Department, Cochin Hospital, Paris Descartes University, Paris, France.
  3. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
  4. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
  5. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
  6. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
  7. Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy.
  8. Rheumatology A Department, Cochin Hospital, Paris Descartes University, Paris, France.
  9. 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.

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