ORIGINAL PAPER
Value of nailfold videocapillaroscopy and high-sensitivity C-reactive protein test in diagnosis of microangiopathy in adolescents with Raynaud’s phenomenon
Submission date: 2013-02-19
Final revision date: 2013-04-11
Acceptance date: 2013-04-11
Online publication date: 2013-06-26
Publication date: 2013-06-28
Reumatologia 2013;51(3):189-194
KEYWORDS
TOPICS
ABSTRACT
Introduction: Nailfold videocapillaroscopy allows assessment of structural abnormalities in the peripheral microcirculation in patients with Raynaud’s syndrome (RS), whereas an increased level of high-sensitivity C-reactive protein (hsCRP) is an acknowledged marker of even low-intensity inflammation of vascular endothelium in many autoimmune diseases, and also in atherosclerosis.
Objective: Assessment of capillaroscopic structural abnormalities in microcirculation with regard to the duration of Raynaud’s phenomenon (RP), the level of hsCRP and the presence of ANA in the serum of children and adolescents with RS.
Material and methods: The study involved 144 patients (104 girls and 40 boys) at the mean age of 16.07 ±3.66 years, who had undergone at least two capillaroscopies. The study patients were divided into 3 groups depending on RP duration ( 2 years, 2–5 years and over 5 years). A STEMI 2000 capillaroscope (ZEISS) was used. Capillaries were measured using the computer program NIS-Elements D2.30 Nikon Corp. Japan. Capillary loops wider than 50 µm were considered dilated. In 59 patients with abnormal patterns of microvessels and low classical inflammatory markers, hsCRP was determined using the immunoturbidimetric method by means of a HITACHI 912 analyser.
Results: Secondary RS was diagnosed in 43 (39.8%) and primary RP in 101 (70.2%) patients. Disorders in capillaroscopic pictures were more enhanced in patients with longer disease duration (p < 0.01). The mean levels of hsCRP (0.44 ±0.47 mg/dl) correlated significantly with patients’ age and RS duration. The mean width of the arterial arm (35.4 ±11.4 µm) and venous arm (45.3 ±26.5 µm) correlated significantly with the mean level of hsCRP (p < 0.05).
Conclusions: In patients with Raynaud’s syndrome, structural abnormalities in microcirculation, together with elevated level of hsCRP, suggest the presence of subclinical vasculitis, with possible endothelial dysfunction.
Further investigation into impairment of microcirculation in patients with secondary Raynaud’s syndrome could support the therapeutic option oriented at suppressing proinflammatory and prothrombotic endothelial activation.
Objective: Assessment of capillaroscopic structural abnormalities in microcirculation with regard to the duration of Raynaud’s phenomenon (RP), the level of hsCRP and the presence of ANA in the serum of children and adolescents with RS.
Material and methods: The study involved 144 patients (104 girls and 40 boys) at the mean age of 16.07 ±3.66 years, who had undergone at least two capillaroscopies. The study patients were divided into 3 groups depending on RP duration ( 2 years, 2–5 years and over 5 years). A STEMI 2000 capillaroscope (ZEISS) was used. Capillaries were measured using the computer program NIS-Elements D2.30 Nikon Corp. Japan. Capillary loops wider than 50 µm were considered dilated. In 59 patients with abnormal patterns of microvessels and low classical inflammatory markers, hsCRP was determined using the immunoturbidimetric method by means of a HITACHI 912 analyser.
Results: Secondary RS was diagnosed in 43 (39.8%) and primary RP in 101 (70.2%) patients. Disorders in capillaroscopic pictures were more enhanced in patients with longer disease duration (p < 0.01). The mean levels of hsCRP (0.44 ±0.47 mg/dl) correlated significantly with patients’ age and RS duration. The mean width of the arterial arm (35.4 ±11.4 µm) and venous arm (45.3 ±26.5 µm) correlated significantly with the mean level of hsCRP (p < 0.05).
Conclusions: In patients with Raynaud’s syndrome, structural abnormalities in microcirculation, together with elevated level of hsCRP, suggest the presence of subclinical vasculitis, with possible endothelial dysfunction.
Further investigation into impairment of microcirculation in patients with secondary Raynaud’s syndrome could support the therapeutic option oriented at suppressing proinflammatory and prothrombotic endothelial activation.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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