Nailfold capilloroscopy in systemic lupus erythematosus

IntroductionNailfold capillaroscopy is a non-invasive technique to recognize peripheral microangiopathy, which is an important feature in SLE.Aim of the workTo study the prevalence of nailfold capillaroscopy (NFC) changes in patients with systemic lupus erythematosus (SLE), find out the patterns of these changes and to correlate these findings with different clinical and laboratory parameters.Patients and methodsForty patients with SLE, all fulfilling the 1997 revised criteria for the classification of SLE were included. All patients included in this study were subjected to full history taking, clinical examination, laboratory investigations as well as nailfold capillaroscopy (NFC) examination.ResultsThe prevalence of nailfold capilloroscopic (NFC) changes in SLE patients was 75%. Nailfold capillaroscopic abnormalities were significantly more frequent in SLE patients than in controls (P < 0.05). Different abnormal NFC changes were seen with the meandering pattern more frequently seen. The afferent and efferent capillary loops diameters were significantly increased in the SLE patients than in the control group (P < 0.05). Some of the NFC abnormalities showed statistical significant correlations with different clinical and laboratory parameters. Capillary loop afferent and efferent diameters were significantly correlated with disease duration (P < 0.05) as well as the occurrence of digital gangrene (P < 0.05). Also the capillary loop afferent diameter was found to be correlated with the intake of cyclophosphamide (P < 0.05).ConclusionSignificant microcirculatory changes occur in systemic lupus erythematosus (SLE) patients as proved by the high prevalence of capillary abnormalities in lupus patients compared to controls by means of nailfold capillaroscopy. Some nailfold capillaroscopy changes e.g. meandering capillaries may complete picture of SLE diagnosis. Duration of SLE disease may have an impact on microcirculation of these patients. The presence of some nailfold capillaroscopy changes in SLE patients may be an alarming sign to fatal ischemia of the digits.