Evaluation of Capillaroscopy Findings in Patients Presenting with Raynaud's Phenomenon (RP): A Retrospective Study

Yıl 2025, Cilt: 51 Sayı: 1, 133 - 138, 27.05.2025

Salim Mısırcı , Ali Ekin , Burcu Yağız , Belkis Nihan Coskun , Hüseyin Ediz Dalkılıç , Yavuz Pehlivan

https://doi.org/10.32708/uutfd.1649435

Öz

Raynaud's phenomenon (RP) is a discoloration of the fingers due to abnormal vasoconstriction in the digital arteries and cutaneous arterioles in response to cold or emotional stress. The study included patients who presented to a tertiary rheumatology clinic with RP between September 2022 and April 2023 and underwent nailfold capillaroscopy (NFC). Of the included patients, 34 (57.6%) were diagnosed with inflammatory rheumatic disease (IRD) and 25 (42.4%) with primary RP. When analysing antibodies, the most common antibody was antinuclear antibody (ANA) (n=39, 66.1%), and most of them were positive with a low titer (n=22, 37.3%). When comparing patients with and without IRD, the capillary density of ≥7 per 1 millimetre was sufficient in all patients in the group without IRD. There was a decrease in capillary density (<7) in 13 (38.24%) patients in the IRD group. When the sizes of capillaries were evaluated, a significant difference was found between the groups in terms of giant capillaries (>50 μm) (p=0.005). In the IRD group, 14 (41.18%) patients had a scleroderma (SCL) pattern and 20 (58.82%) had a non-SCL pattern. In the non-IRD group, all but two patients had a non-SCL pattern. Age, ANA positivity, high ANA titer, presence of giant capillaries and SCL pattern had a positive significant discriminatory effect (p<0.05) in distinguishing between patients with and without IRD. NFC assessment is an important tool in the diagnosis of IRDs such as systemic sclerosis. Advanced age, SCL pattern, giant capillaries and ANA positivity should be warning signs of secondary RP.

Anahtar Kelimeler

inflammatory rheumatic disease , capillaroscopy , raynoud phenomenon , systemic sclerosis

Raynaud Fenomeni (RF) ile Başvuran Hastaların Kapilleroskopi Bulgularının Değerlendirilmesi: Retrospektif Çalışma Raynaud Fenomeni (RF) ve Kapilleroskopi

Öz

Raynaud fenomeni (RF), soğuğa veya duygusal strese karşı dijital arterlerde ve kutanöz arteriyollerdeki anormal vazokonstriksiyona bağlı olarak gelişen parmaklardaki renk değişikliğidir. Çalışmaya Eylül 2022-Nisan 2023 tarihleri arasında üçüncü basamak bir romatoloji polikliniğine RF ile başvurup tırnak kıvrımı kapilleroskopisi (TKK) yapılan hastalar dahil edildi. Dahil edilen hastaların 34 (%57,6)’üne inflamatuvar romatizmal hastalık (İRH) tanısı konulduğu, 25 (%42,4)’inin ise primer RF olarak kabul edildiği belirlendi. Antikorlar değerlendirildiğinde, en sık saptanan anti-nükleer antikor (ANA) (n=39, %66,1) olup, çoğunluğu düşük titrede pozitifti (n=22, %37,3). İRH saptanan ve saptanmayan hastalar karşılaştırıldığında, İRH olmayan gruptaki hastaların tamamında kapiller dansite her 1 milimetrelik alanda ≥7 olup yeterliydi. İRH grubundaki hastaların 13’ünde kapiller dansitede azalma (<7) mevcuttu. Kapillerlerin boyutları değerlendirildiğinde, gruplar arasında dev kapiller (>50 μm) açısından anlamlı farklılık saptandı (p=0,005). İRH grubundaki hastaların 14’ünde SCL paterni, 20 (%58,82)’sinde ise non-SCL paterni saptanmıştı. İRH olmayan gruptaki hastaların sadece ikisi hariç tamamında non-SCL paterni saptanmıştı. Yaş, ANA pozitifliği, yüksek titre ANA pozitifliği, dev kapiller görülmesi ve SCL paterninin İRH olan ve olmayan hastaları ayırmada pozitif anlamlı ayırıcı (p<0,05) etkisi gözlenmiştir. TKK değerlendirmesi, sistemik skleroz gibi İRD'lerin tanısında önemli bir araçtır. İleri yaş, SCL paterni, dev kapiller ve ANA pozitifliği sekonder RF açısından uyarıcı olmalıdır.

Anahtar Kelimeler

inflamatuvar romatizmal hastalık , kapilleroskopi , raynoud fenomeni , sistemik skleroz

Kaynakça

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