Raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship
Raynaud’s phenomenon (RF) is an exaggerated vasospastic response to cold, physical or emotional stimuli, of clinical diagnosis, being able to be primary or secondary. Capillaroscopy and immunology help to determine his etiology. The aim was to describe the capillaroscopic characteristics and associa...
| Autores principales: | , , , , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2019
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/26064 |
| Aporte de: |
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I10-R327-article-26064 |
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| record_format |
ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
Raynaud capillaroscopy Raynaud capilaroscopia |
| spellingShingle |
Raynaud capillaroscopy Raynaud capilaroscopia Quaglia, M Alonso, C Maldini, C Savio, V Albiero, A Gobbi, C Alba, P Raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship |
| topic_facet |
Raynaud capillaroscopy Raynaud capilaroscopia |
| author |
Quaglia, M Alonso, C Maldini, C Savio, V Albiero, A Gobbi, C Alba, P |
| author_facet |
Quaglia, M Alonso, C Maldini, C Savio, V Albiero, A Gobbi, C Alba, P |
| author_sort |
Quaglia, M |
| title |
Raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship |
| title_short |
Raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship |
| title_full |
Raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship |
| title_fullStr |
Raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship |
| title_full_unstemmed |
Raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship |
| title_sort |
raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship |
| description |
Raynaud’s phenomenon (RF) is an exaggerated vasospastic response to cold, physical or emotional stimuli, of clinical diagnosis, being able to be primary or secondary. Capillaroscopy and immunology help to determine his etiology.
The aim was to describe the capillaroscopic characteristics and association to clinical and immunological manifestations in a cohort of patients with RF.
We conducted an observational, descriptive, retrospective study, reviewing the capillaroscopies performed between June/2014 to June 2018, with an ARCANO Optical Capillaroscope. Demographic data, comorbidities, toxicities, date of onset of RF, macroscopic lesions (digital ulcers, nail lesions, telangiectasias, puffy fingers and sclerodactyly), clinical manifestations (interstitial lung disease, pulmonary hypertension), sicca syndrome, muscle weakness, cardiac involvement, gastroesophageal reflux, arthritis) and immunological laboratory (antinuclear antibodies -ANA-, anticentromere, anti-Scl 70, anti – RO, anti – LA, anti RNP, anti DNA, Anticardiolipins, anti – Sm, anti Jo1 and anti Mi2). The diagnosis was classified as: Scleroderma (ES), other collagenopathies, undifferentiated collagenopathy (defined by negative autoimmune serology, compatible clinical and abnormal capillaroscopy) and primary RF. Number of capillaries (NofC), avascular areas, dystrophies, ectasias, megacapillaries, dilations and microhemorrhages were evaluated by capillaroscopy. The capillaroscopic patterns were classified as early (the combination of few enlarged/giant capillaries, few capillary microhemorrhages, a relatively well-preserved capillary distribution and no evident loss of capillaries), active (frequent giant capillaries, frequent capillary microhemorrhages, moderate loss of capillaries, mild disorganization of the capillary architecture and absent or mild ramified capillaries) and late (irregular enlargement of the capillaries, few or absent giant capillaries and microhemorrhages, severe loss of capillaries with large avascular areas, disorganization of the normal capillary array and ramified/bushy capillaries). Quantitative variables were expressed in median and interquartile range and qualitative variables in proportion and percentage. They were compared with Student and Fischer test, respectively.
A total of 138 capillaroscopies were done to 127 patients. We analyzed the clinical records of 70 (57,9%); 10 (7,2%) has a second capillaroscopy to follow up. SD patterns: 29 active, 17 early, 20 normal, no significant differences in clinical manifestations or immunology between groups, except ANA, its was more frequent in active pattern (p = 0.04). In follow up capillaroscopies, 3 patients have different pattern; one with LES was reclassified as Scleroderma with the same capillaroscopy.
The more frequent pattern was active and its was associated with ANA, while there was not relationship between clinical manifestations with different capillaroscopic patterns. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2019 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/26064 |
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I10-R327-article-260642024-08-27T18:26:46Z Raynaud's phenomenon: description of capillaroscopic patterns and their clinical and immunological relationship Fenómeno de Raynaud: descripción de patrones capilaroscopicos y su traducción clínico-inmunológica Quaglia, M Alonso, C Maldini, C Savio, V Albiero, A Gobbi, C Alba, P Raynaud capillaroscopy Raynaud capilaroscopia Raynaud’s phenomenon (RF) is an exaggerated vasospastic response to cold, physical or emotional stimuli, of clinical diagnosis, being able to be primary or secondary. Capillaroscopy and immunology help to determine his etiology. The aim was to describe the capillaroscopic characteristics and association to clinical and immunological manifestations in a cohort of patients with RF. We conducted an observational, descriptive, retrospective study, reviewing the capillaroscopies performed between June/2014 to June 2018, with an ARCANO Optical Capillaroscope. Demographic data, comorbidities, toxicities, date of onset of RF, macroscopic lesions (digital ulcers, nail lesions, telangiectasias, puffy fingers and sclerodactyly), clinical manifestations (interstitial lung disease, pulmonary hypertension), sicca syndrome, muscle weakness, cardiac involvement, gastroesophageal reflux, arthritis) and immunological laboratory (antinuclear antibodies -ANA-, anticentromere, anti-Scl 70, anti – RO, anti – LA, anti RNP, anti DNA, Anticardiolipins, anti – Sm, anti Jo1 and anti Mi2). The diagnosis was classified as: Scleroderma (ES), other collagenopathies, undifferentiated collagenopathy (defined by negative autoimmune serology, compatible clinical and abnormal capillaroscopy) and primary RF. Number of capillaries (NofC), avascular areas, dystrophies, ectasias, megacapillaries, dilations and microhemorrhages were evaluated by capillaroscopy. The capillaroscopic patterns were classified as early (the combination of few enlarged/giant capillaries, few capillary microhemorrhages, a relatively well-preserved capillary distribution and no evident loss of capillaries), active (frequent giant capillaries, frequent capillary microhemorrhages, moderate loss of capillaries, mild disorganization of the capillary architecture and absent or mild ramified capillaries) and late (irregular enlargement of the capillaries, few or absent giant capillaries and microhemorrhages, severe loss of capillaries with large avascular areas, disorganization of the normal capillary array and ramified/bushy capillaries). Quantitative variables were expressed in median and interquartile range and qualitative variables in proportion and percentage. They were compared with Student and Fischer test, respectively. A total of 138 capillaroscopies were done to 127 patients. We analyzed the clinical records of 70 (57,9%); 10 (7,2%) has a second capillaroscopy to follow up. SD patterns: 29 active, 17 early, 20 normal, no significant differences in clinical manifestations or immunology between groups, except ANA, its was more frequent in active pattern (p = 0.04). In follow up capillaroscopies, 3 patients have different pattern; one with LES was reclassified as Scleroderma with the same capillaroscopy. The more frequent pattern was active and its was associated with ANA, while there was not relationship between clinical manifestations with different capillaroscopic patterns. El Fenómeno de Raynaud (FR) es una respuesta vasoespástica exagerada al frío, estímulos físicos o emocionales, de diagnóstico clínico, pudiendo ser primario o secundario. La capilaroscopía y la inmunología ayudan a determinar su etiología. El objetivo fue describir las características capilaroscópicas y asociación a manifestaciones clínicas e inmunológicas en una cohorte de pacientes con FR. Realizamos un estudio obsevacional, descriptivo, retrospectivo, revisando las capilaroscopías efectuadas entre junio/2014 a junio/2018, realizadas con Capilaroscopio Óptico ARCANO. Se obtuvieron datos demográficos, comorbilidades, tóxicos, fecha de inicio del FR, lesiones macroscópicas (úlceras digitales, lesiones periungueales, telangiectasias, puffy fingers y esclerodactilia), manifestaciones clínicas (enfermedad pulmonar intersticial, hipertensión pulmonar), síndrome sicca, debilidad muscular, compromiso cardíaco, reflujo gastroesofágico, artritis) y laboratorio inmunológico (anticuerpos antinucleares (ANA), anticentrómero, anti-Scl70, anti-RO, anti-LA, antiRNP, antiDNA, anticardiolipinas, anti-Sm, anti-JO1 y anti-MI2). El diagnóstico se clasificó en: Esclerodermia (ES), otras colagenopatías, colagenopatía indiferenciada (definido por serología autoinmune negativa, clínica compatible y capilaroscopía anormal) y FR primario. En la capilaroscopía se evaluaron: número de capilares (NdC), zonas avasculares, distrofias (tortuosidades, ovillos, desorganización), ectasias, megacapilares, dilataciones y microhemorragias. El patrón capilaroscópico se clasificó en temprano (algunos megacapilares y microhemorragias, buena distribución, NdC conservado), activo (frecuentes megacapilares y microhemorragias, moderada pérdida de capilares, leves ramificaciones, leve desorganización) tardío (megacapilares y microhemorragias ausentes, severa pérdida de capilares, extensas áreas avasculares, capilares ramificados o en ovillo, intensa desorganización). Las variables cuantitativas fueron expresadas en mediana y rango intercuartil y las cualitativas en proporción y porcentaje. Se compararon con el test de Student y Fischer, respectivamente. Se realizaron 138 capilaroscopías, correspondientes a 127 pacientes. Se analizó la historia clínica de 70 (57,9%); de los cuales 10 (7,2%) tuvieron segunda capilaroscopia de seguimiento. Patrones: 29 activo, 17 temprano, 20 normal, sin diferencias significativas en manifestaciones clínicas o inmunológicas entre ellos, excepto el ANA que fue más frecuente (p = 0.04) en patrón activo. En capilaroscopías de seguimiento, 3 pacientes progresaron de patrón; uno con diagnóstico de LES fue reclasificado como ES con igual capilaroscopía. El patrón capilaroscópico más frecuente fue el activo, y se asoció con ANA, mientras no se encontró relación entre las manifestaciones clínicas con los distintos patrones. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019-10-29 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/26064 Revista de la Facultad de Ciencias Médicas de Córdoba.; 2019: Suplemento JIC XX Revista de la Facultad de Ciencias Médicas de Córdoba; 2019: Suplemento JIC XX Revista da Faculdade de Ciências Médicas de Córdoba; 2019: Suplemento JIC XX 1853-0605 0014-6722 10.31053/1853.0605.v76.nSuplemento spa https://revistas.unc.edu.ar/index.php/med/article/view/26064/27914 Derechos de autor 2019 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |