The Clinical Significance Of Nailfold Capillary Microscopic Examination In The Patients With Co Ech Tissue Diseases

Song, Kwang Seon; Hong, Chein Soo; Lee, Soo Kon

Abstract

OBJECTIVE
Raynaud's phenomenon is a vascular disorder characterized by reversible spasm of arteries of fingers. It is the first symptom in 70% of partlents with systemic sclerosis. The more systemic involvment the worse prognosis is expected in patients with systemic sclerosis. A more reliable indication of systemic sclerosis is the microvascular involvement by the disease (characteristic patterns of capillary abnormality in the nail-fold). Our puroses were to evaluate the significance of the degree of nailfold capillary abnormlitry in making the diagnosis fo systemic sclerosis, and in determining organ involvement in patients with systemic sclerosis.
METHODS
Twenty-six patients with Raynaud's phenomenon whose diagnosis were systemic sclerosis(10 patients), SLE(10 patient), Raynaud's disease(6 patients) were observed for nailfold capillary abnormalities by widefield microscopy.
RESULTS
Capillary abnormalities were seen in 100% of the systemic sclerosis (10 patients), 30% of the SLE (3 patients) and 50% of the Raynaud's disease (3 patients). A significant correlation between degree of finger lesions (r=0.718) or organ involvement (X2=20.4, p=0.015) and capillary abnormality class was found although a significant correlation was not found between the duration of the disease and the degree of capillary abnormality in patients with systemic sclerosis (r=0.32).
CONCLUSIONS
Nailfold capillary abnormality can easily be observed and could be used as an assistive tools for the diagnosis and prediction of prognosis and extent of organ involvement in patients with Raynaud's phenomenon especially in patients with systemic sclerosis.