Rheumatology (Oxford, England) · 2026
Nailfold videocapillaroscopy abnormalities in autoimmune inflammatory myopathy subsets.
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Leclair Valérie, Cotton Thaisa, Shen Hao Cheng, Berger Claudie, Troyanov Yves, Hudson Marie, Gyger Geneviève, Canadian Inflammatory Myopathy Study
Аннотация
OBJECTIVES: Nailfold videocapillaroscopy (NVC) alterations have been described in autoimmune inflammatory myopathies (AIM). This study aimed to describe NVC abnormalities in AIM subsets using a clinico-sero-pathological approach.
METHODS: We studied subjects from the Canadian Inflammatory Myopathy Study (CIMS), a prospective AIM cohort. NVC images were acquired using the DS MEDICA Videocap (×200 magnification). Capillary density was scored quantitatively and semi-quantitatively. Ectasias, giant capillaries, ramified capillaries and microhaemorrhages were scored as present or absent and with a standardized semi-quantitative scale (0 = none, 1=≤33%, 2 = 33-66% and 3=≥66% abnormal capillaries/total capillaries per mm). NVC patterns (i.e. scleroderma early/active/late, scleroderma-like, non-specific and normal) were described. NVC features and patterns were compared between AIM subsets.
RESULTS: We included 99 AIM subjects: 41 dermatomyositis, 24 scleromyositis, 16 anti-synthetase syndrome, seven immune-mediated necrotizing myopathy, eight inclusion body myositis and three polymyositis. A total of 71% were female, and the median disease duration was 1 year [IQR; 0.4-2.8]. The most frequent NVC abnormality was decreased capillary density in dermatomyositis (95%), scleromyositis (92%) and anti-synthetase syndrome (87%). Qualitatively, 44% of subjects had abnormal NVC, 25% non-specific NVC abnormalities and 30% normal NVC. NVC patterns were not discriminant between dermatomyositis, scleromyositis and anti-synthetase syndrome. NVC abnormalities were absent in immune-mediated necrotizing myopathy, inclusion body myositis and polymyositis.
CONCLUSION: Dermatomyositis, scleromyositis and anti-synthetase syndrome showed frequent NVC abnormalities, although no NVC pattern was associated with a particular subset in our study. However, NVC may help distinguish between these subsets and immune-mediated necrotizing myopathy, inclusion body myositis and polymyositis.
METHODS: We studied subjects from the Canadian Inflammatory Myopathy Study (CIMS), a prospective AIM cohort. NVC images were acquired using the DS MEDICA Videocap (×200 magnification). Capillary density was scored quantitatively and semi-quantitatively. Ectasias, giant capillaries, ramified capillaries and microhaemorrhages were scored as present or absent and with a standardized semi-quantitative scale (0 = none, 1=≤33%, 2 = 33-66% and 3=≥66% abnormal capillaries/total capillaries per mm). NVC patterns (i.e. scleroderma early/active/late, scleroderma-like, non-specific and normal) were described. NVC features and patterns were compared between AIM subsets.
RESULTS: We included 99 AIM subjects: 41 dermatomyositis, 24 scleromyositis, 16 anti-synthetase syndrome, seven immune-mediated necrotizing myopathy, eight inclusion body myositis and three polymyositis. A total of 71% were female, and the median disease duration was 1 year [IQR; 0.4-2.8]. The most frequent NVC abnormality was decreased capillary density in dermatomyositis (95%), scleromyositis (92%) and anti-synthetase syndrome (87%). Qualitatively, 44% of subjects had abnormal NVC, 25% non-specific NVC abnormalities and 30% normal NVC. NVC patterns were not discriminant between dermatomyositis, scleromyositis and anti-synthetase syndrome. NVC abnormalities were absent in immune-mediated necrotizing myopathy, inclusion body myositis and polymyositis.
CONCLUSION: Dermatomyositis, scleromyositis and anti-synthetase syndrome showed frequent NVC abnormalities, although no NVC pattern was associated with a particular subset in our study. However, NVC may help distinguish between these subsets and immune-mediated necrotizing myopathy, inclusion body myositis and polymyositis.