TITLE:
Periungual Capillaroscopy Findings in a Series of Patients with Granulomatosis with Polyangiitis (Wegener): An Observational Study
AUTHORS:
Uceda Montañés Julia, Martínez Pérez Rosalía, Velloso Feijoo María Luisa, Marenco de la Fuente José Luis
KEYWORDS:
Periungual Capillaroscopy; Vasculitis; Granulomatosis with Polyangiitis
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.3 No.2,
May
24,
2013
ABSTRACT: Introduction: Periungual capillaroscopy studies skin microcirculation. Its main indication is in the differential diagnosis of Raynaud’s phenomenon as well as diagnosis and prognosis of systemic sclerosis (SS). Many rheumatic diseases present characteristic capillaroscopic alterations, but little is known at present about the alterations in skin microcirculation of systemic vasculitis. Objective: Our main objective was to study the alterations in skin microcirculation by capillaroscopy in patients with granulomatosis with polyangiitis (GPA). The secondary objective was to evaluate the association of capillaroscopic alterations with systemic alteration. Material and Methods: We studied patients in our unit with GPA, and we collected demographic and clinical variables. Periungual capillaroscopy was performed on all patients, and always by the same investigator. Results: We reviewed 10 patients with a mean age of 55.7. They were predominantly women. We found capillaroscopic alterations in 8 of the 10 patients. Morphological alteration was the most common finding (62.5%), followed by bleeding (50%). We found no mega-capillaries or neovessels. These findings were not related to any specific organ system involvement. Discussion: The tortuous pattern with bleeding was predominant in our series, with lower capillary density, findings which were unrelated to any specific organ system involvement. A single study describes capillaroscopic alterations in GPA, detecting a high percentage (92%) of avascular areas, in contrast with the predominance of a twisting pattern and bleeding found in our study. Further studies are warranted to confirm these results.