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  • Title: [Morphological alterations in nailfold capillaroscopy and the clinical picture of vascular involvement in autoimmune diseases: systemic lupus erythematosus and type 1 diabetes].
    Author: Kuryliszyn-Moskal A, Ciołkiewicz M, Dubicki A.
    Journal: Ann Acad Med Stetin; 2010; 56 Suppl 1():73-9. PubMed ID: 21365947.
    Abstract:
    INTRODUCTION: Systemic lupus erythematosus (SLE) and type 1 diabetes mellitus (DM) belong to the group of autoimmune diseases presenting with a wide range of organ manifestations. Microvascular abnormalities seem to play a crucial role in the development of persistent multi-organ complications in both diseases. The aim of this study was to determine the relationship between microvascular changes examined with nailfold capillaroscopy and organ involvement. MATERIAL AND METHODS: We eurolled 76 SLE patients, 106 patients with type 1 diabetes, and 40 healthy controls. RESULTS: Morphological changes were observed with nailfold capillaroscopy in 86 (81%) diabetics and in 70 (92.1%) SLE patients. Severe capillaroscopic changes were disclosed in 32 out of 54 (59%) diabetic patients with microangiopathy and in only 7 out of 52 (13%) patients without microangiopathy. In the SLE group, severe capillaroscopic abnormalities were found in 18 out of 34 (52.9%) patients with organ involvement and in 9 out of 42 (21.4%) patients without organ involvement. The capillaroscopic score was significantly higher in diabetic patients with microangiopathic complications in comparison to patients without microangiopathy (p < 0.001). Moreover, diabetic patients with advanced microvascular changes had longer disease durations than patients with mild abnormalities. A similar comparison between SLE patients with and without systemic manifestations showed significantly higher capillaroscopic scores in the group with organ involvement (p < 0.001). Furthermore, a positive correlation between capillaroscopic score and disease activity was observed in SLE patients (p < 0.01). CONCLUSIONS: Our findings suggest that abnormalities in nailfold capillaroscopy reflect the extent of microvascular involvement and are associated with organ involvement in SLE and diabetes.
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