Capillaroscopic alterations characterization in patients with primary systemic vasculitis.

BACKGROUND

Clinical manifestations in systemic vasculitis may be due to decreased arterial and venous flow because inflammation. There are few studies characterizing the changes in microcirculation in these diseases. Capillaroscopy can help detect changes in the microvasculature.

OBJECTIVE

Characterize capillaroscopy alterations in primary systemic vasculitis's patients and associated factors.

PATIENTS: Cross-sectional, observational, and comparative study. Thirty-two patients with systemic vasculitis (PGA n = 17, PAM n = 4, AT n = 4, PHS n = 3, PAN n = 2, and others n = 2) and 32 controls matched for age and sex were included. All participants underwent capillaroscopy of eight fingers (2nd to 5th finger of each hand), obtaining at least two images of each finger studied for analysis.

RESULTS

No characteristic pattern was found, only nonspecific changes. Avascular areas (84.4% vs. 59.4%, p = .026), microhemorrhages (34.4% vs. 6.3%, p < .005), and neoangiogenesis (34.4% vs. 0%, p < .001) were more frequent in the vasculitis group compared to the control group. The duration of the disease had moderate correlation with capillary density (r = -.31, p = .010) and avascular areas (r = .40, p = .001). VDI had moderate correlation (r = .50, p = .050) with capillary density. Capillary neoangiogenesis correlated with the diagnosis of vasculitis (r = -.40, p = .001) and ischemic lesions (r = .371, p = .003). The factors associated with capillaroscopic changes were: disease activity (BVAS3), cumulative damage (VDI) and presence of ischemic lesions.

DISCUSSION AND

CONCLUSIONS

The search for capillaroscopic abnormalities in patients with systemic vasculitis may be useful in patients with a history of ischemic lesions and longer disease duration.