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Nailfold capillaroscopic findings in primary Sjögren`s syndrome: clinical and serological correlations
K.G. Capobianco, R.M. Xavier, M. Bredemeier, V.G. Restelli, J.C.T. Brenol
CER2676
2005 Vol.23, N°6
PI 0789, PF 0794
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PMID: 16396696 [PubMed]
Abstract
OBJECTIVES:
To describe the capillaroscopic abnormalities observed in patients with primary Sjögren`s Syndrome (pSS), associating them with clinical and serologic features, and comparing these findings to those observed in normal controls.
METHODS:
Sixty-one consecutive patients with pSS were studied by clinical evaluation, serology, and nailfold capillary microscopy (NCM). Twenty-one normal controls were also examined. Capillaroscopic findings were recorded in a standardized way by a blinded observer. Capillary loss on NCM was evaluated using a deletion score.
RESULTS:
NCM was normal in 59.0% of pSS patients; 29.5% had non-specific abnormalities, and 11.5% presented a SD-like pattern. Patients presented a higher deletion score than controls (p < 0.001). Other capillaroscopic parameters (number of dilated, bizarre, and meandering capillaries; capillary hemorrhages; venous plexus visibility) did not differ significantly between patients and controls. Among patients, the deletion score was higher in those with systemic manifestations (p = 0.022) and Raynaud`s phenomenon (p = 0.050). No association between the presence of antinuclear antibodies, rheumatoid factor, anti-SSA/Ro and anti-SSB/La with qualitative or quantitative NCM findings was found. Among the 7 patients with SD-like pattern on NCM, 6 had Raynaud`s phenomenon, but only 2 presented autoantibodies related to systemic sclerosis (1 with anticentromere and 1 with low titer antitopoisomerase I). None of these patients met the ACR criteria for SSc.
CONCLUSIONS:
SD-like pattern on NCM is observed in a small but significant proportion of pSS patients. The association of systemic involvement with a higher deletion score may be related to the hypothesis that these manifestations represent clinical expressions of systemic vasculitis.
