Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
Turk J Med Sci. 2019 Oct 24;49(5):1303-1307. doi: 10.3906/sag-1812-223.
BACKGROUND/AIM: Abnormal capillaroscopic findings have been reported in vasculitic syndromes such as Behçet’s disease, Henoch–Schönlein purpura, and Wegener’s granulomatosis. This study was conducted to define the capillaroscopic changes in patients with Takayasu arteritis (TA).
We studied 28 TA patients (27 females). The nail folds from the 2nd to 5th fingers on both hands were examined with video capillaroscopy for all. A patient was defined as having an abnormal capillaroscopic examination if more than 1 morphologic abnormality was present in at least 2 nail folds.
The median capillary density of TA patients was 9 (range: 9–11). There were no patients with capillary disorganization or avascular areas. Tortuous capillaries were detected in all patients. The other common morphological capillary abnormalities included enlarged/dilated capillaries (39.3%), branching capillaries (35.7%), and hemorrhages (32.1%). Only 1 patient had giant capillaries with early scleroderma-like pattern. Overall, there were 11 (39.3%) patients with abnormal capillaroscopic findings. There were more patients with abnormal capillaroscopic findings in the subgroup of TA patients whose upper extremity blood pressure could not be measured as compared to those whose blood pressure could be measured (66.7% vs. 26.3% patients; P = 0.04).
Capillaroscopic abnormalities are frequently seen in TA patients. We consider that abnormal capillaroscopic findings in TA patients reflect the impaired blood flow due to narrowed or occluded arteries rather than the primary capillary involvement of the disease process.
背景/目的:异常毛细血管变化已在血管炎综合征中被报道,如贝切特病、过敏性紫癜和韦格纳肉芽肿。本研究旨在定义 Takayasu 动脉炎(TA)患者的毛细血管变化。
我们研究了 28 名 TA 患者(27 名女性)。所有患者均进行视频毛细血管检查,观察双手第 2-5 指的指甲褶皱。如果至少 2 个指甲褶皱中存在 1 种以上形态异常,则定义为异常毛细血管检查。
TA 患者的毛细血管密度中位数为 9(范围:9-11)。无毛细血管结构紊乱或无血管区患者。所有患者均检测到扭曲的毛细血管。其他常见的形态学毛细血管异常包括扩大/扩张的毛细血管(39.3%)、分支毛细血管(35.7%)和出血(32.1%)。仅 1 名患者有早期硬皮病样模式的巨大毛细血管。总体而言,有 11 名(39.3%)患者有异常毛细血管变化。上肢血压无法测量的 TA 患者中异常毛细血管变化的患者比例高于血压可测量的患者(66.7%比 26.3%的患者;P=0.04)。
TA 患者常出现毛细血管异常。我们认为 TA 患者的异常毛细血管变化反映了由于动脉狭窄或闭塞导致的血流受损,而不是疾病过程中的原发性毛细血管受累。