Diagnostic potential of in vivo capillary microscopy in scleroderma and related disorders

TLDR

The study included 173 patients with various connective tissue diseases, including 50 systemic sclerosis, 60 systemic lupus erythematosus, 26 mixed connective tissue disease, 11 Raynaud's disease, and 26 other rheumatic disorders. In vivo capillary microscopy was used to assess the prevalence of scleroderma‑type capillary abnormalities across three rheumatic disease centers. Scleroderma‑type capillary abnormalities were present in 82 % of systemic sclerosis patients and 54 % of mixed connective tissue disease patients, but only 2 % of systemic lupus erythematosus patients, and a single Raynaud’s disease patient with such changes later developed scleroderma, indicating these abnormalities are not merely a manifestation of Raynaud’s phenomenon.

Abstract

Abstract The prevalence of scleroderma‐type capillary abnormalities, as observed by in vivo microscopy, was determined in 173 patients from three rheumatic disease centers. The patients had a variety of connective tissue diseases: scleroderma (systemic sclerosis) 50; systemic lupus erythematosus 60; mixed connective tissue disease 26; Raynaud's disease 11; other rheumatic disorders 26. Enlarged and deformed capillary loops surrounded by relatively avascular areas, most prominently in the nailfolds, were found in 82% of patients with scleroderma and in 54% with mixed connective tissue disease. The rarity of these abnormalities in systemic lupus erythematosus (2%) despite the presence of Raynaud's phenomenon suggests that they are not an expression of the Raynaud's phenomenon frequently associated with scleroderma and mixed connective tissue disease. The single patient with Raynaud's disease and sclerodermatype capillary changes subsequently developed scleroderma.