Capilaroscopía en el diagnóstico de las enfermedades autoinmunes sistémicas

Verónica Garra; Natalia Danese; Martín Rebella; Ernesto Cairoli

Authors

Verónica Garra Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Médica C, Unidad Docente Asistencial. Asistente
Natalia Danese Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Médica C, Unidad Docente Asistencial. Asistente
Martín Rebella Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Médica C. Asistente
Ernesto Cairoli Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Clínica Médica C. Profesor Agregado

Keywords:

MICROSCOPIC ANGIOSCOPY, AUTOIMMUNE DISEASES

Abstract

Introduction: nailfold capillaroscopy (NC) consists of the in vivo observation of capillary microcirculation, which usually presents three patterns (tortuos, sclerodermiform and normal).
Objective: to describe capillary alterations in patients who consulted at the Systemic Autoimmune Diseases Unit of the Clínicas Hospital, between August 2009 and October 2010.
Patients, material and methods: we conducted a descriptive, retrospective and qualitative study of capillaroscopy patterns.
Results: the medical records and NC of 110 patients were reviewed (102 women), average age was 46.6 ± 17.5 years old, being the largest group represented by 34 (31%) patients with systemic sclerosis. Patterns found in the NC were normal in 38% of cases and pathological in 62% of them. Eighty eight per cent of patients with systemic sclerosis presented a pathological NC, and 74% of the latter corresponded to a sclerodermiform pattern. We found a pathololgical pattern in 66% of patients with autoimmune diseases (except for systemic sclerosis), where 27% corresponded to a sclerodermiform pattern.
Conclusions: NC contributed to the study of the Raynaud phenomenon and autoinmune diseases in different ways. Identifying a sclerodermiform pattern highly suggested the presence of a systemic autoimmune disease. The NC, together with clinical findings and the appropriate biological markers gains value and specificity in the diagnosis, and it thus should be a part of the clinical assessment of patients with the Raynaud's disease and a clinical or analytical suspicion of systemic autoimmune disease.

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