Abnormal Nailfold Capillaroscopy Is Common in Patients with Connective Tissue Disease and Associated with Abnormal Pulmonary Function Tests

Anniek M. van Roon*, Cato C. Huisman, Arie M. van Roon, Dan Zhang, Ara J. Stel, Andries J. Smit, Hendrika Bootsma, Douwe J. Mulder

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)

Abstract

Objective. To assess the presence of a systemic sclerosis (SSc) pattern on nailfold capillary microscopy (NCM) in patients with Raynaud phenomenon (RP) and to explore its association with abnormal pulmonary function tests (PFT).

Methods. NCM patterns were assessed in 759 consecutive patients with RP. Patterns were classified as normal (n = 354), nonspecific (n = 159), or SSc pattern (n = 246). Abnormal PFT was defined as forced vital or diffusion capacity <70%. Patients were classified as primary RP (n = 245), or secondary: no definite diagnosis (n = 391), SSc (n = 40), primary Sjogren syndrome (pSS; n = 30), systemic lupus erythematosus (SLE; n = 30), mixed connective tissue disease (MCTD; n = 7), rheumatoid arthritis (RA; n = 15).

Results. An SSc pattern on NCM was frequently observed in most patients with a definite diagnosis: SSc (88%), pSS (33%), SLE (17%), MCTD (71%), and RA (13%). In patients without definite diagnosis, 17% had a normal NCM pattern, 35% nonspecific, and 48% SSc pattern. Abnormal PFT was more frequent in patients with an SSc pattern (35.9% vs 19.5%, p = 0.002), even when corrected for SSc diagnosis (p = 0.003). Absence of an SSc pattern had high negative predictive value (88%); positive predictive values were low.

Conclusion. SSc pattern on NCM is common in patients with RP, and in those with connective tissue diseases other than SSc. It is associated with a higher prevalence of abnormal PFT, independent of the presence of an SSc diagnosis. Although these data need validation in a prospective setting, they underline the importance of NCM in RP and putative value to stratify the risk of pulmonary involvement in early stages of disease.

Original languageEnglish
Pages (from-to)1109-1116
Number of pages8
JournalJournal of Rheumatology
Volume46
Issue number9
DOIs
Publication statusPublished - 1-Sep-2019

Keywords

  • RAYNAUD PHENOMENON
  • MICROSCOPIC ANGIOSCOPY
  • SYSTEMIC SCLEROSIS
  • CONNECTIVE TISSUE DISEASES
  • RESPIRATORY FUNCTION TESTS
  • SYSTEMIC-LUPUS-ERYTHEMATOSUS
  • PRIMARY SJOGRENS-SYNDROME
  • HAND-HELD DERMATOSCOPE
  • CLASSIFICATION CRITERIA
  • RAYNAUDS-PHENOMENON
  • RHEUMATOLOGY/EUROPEAN LEAGUE
  • ORGAN INVOLVEMENT
  • AMERICAN-COLLEGE
  • SCLEROSIS
  • MICROSCOPY

Cite this