Makarem Yasmine S, Selim Zahraa I, Ismail Sherif, Imam Mekkawy Amera, Galal Hanan, El Nouby Fatma H
Rheumatology & Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Rheumatology & Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Reumatol Clin (Engl Ed). 2025 Mar;21(3):501840. doi: 10.1016/j.reumae.2025.501840.
Systemic lupus erythematosus (SLE) is an autoimmune disease that causes multiple vascular complications, including endothelial cell damage. Nailfold capillaroscopy is the most effective non-invasive imaging technique for assessing the morphology of nailfold capillaries, and approximately half of the SLE patients have non-specific nailfold capillaroscopy abnormalities. Anti-uridin1-ribonucleoprotein antibodies are present in systemic lupus erythematosus patients with Raynaud's phenomenon, pulmonary artery hypertension, esophageal dysmotility, myopathy, and no severe renal involvement.
To detect different patterns of nailfold capillaroscopic changes in SLE patients, their correlation with SLE disease activity, and anti-U1-RNP antibodies.
A case-control study included eighty-six SLE patients, and disease activity was assessed using the SLEDAI-2K. All patients had a nailfold capillaroscopic examination. Anti-uridin1-ribonucleoprotein antibodies were measured in all patients.
Anti-uridin1-ribonucleoprotein antibodies had a significant inverse correlation with microhemorrhages and a significant direct relationship between anti-dsDNA antibody positivity and the presence of microhemorrhage. Additionally, a significant direct correlation was found between giant capillaries, venous plexus visibility, and higher ESR and CRP. Raynaud's phenomenon was significantly correlated with SLEDAI-2K, swollen joints, tender joints, and anti-dsDNA. Multiple linear regression analysis revealed that microhemorrhages and giant capillaries were the most significant predictors of lupus disease activity.
Our findings highlight the prevalence of microvascular abnormalities in systemic lupus erythematosus, including tortuosity, crossing, elongation, microhemorrhages, and giant capillaries, emphasizing the importance of NFC in assessing microcirculation and disease activity. Also, it adds to the growing body of evidence supporting the prognostic value of capillary abnormalities, particularly microhemorrhages and giant capillaries, as predictors of disease activity in systemic lupus erythematosus patients. Nailfold capillaroscopic examination can assess lupus activity and potentially predict the risk of serious complications.
系统性红斑狼疮（SLE）是一种自身免疫性疾病，可导致多种血管并发症，包括内皮细胞损伤。甲襞毛细血管镜检查是评估甲襞毛细血管形态最有效的非侵入性成像技术，约一半的SLE患者存在非特异性甲襞毛细血管镜异常。抗尿苷1核糖核蛋白抗体存在于患有雷诺现象、肺动脉高压、食管动力障碍、肌病且无严重肾脏受累的系统性红斑狼疮患者中。
检测SLE患者甲襞毛细血管镜检查变化的不同模式、其与SLE疾病活动度的相关性以及抗U1-RNP抗体。
一项病例对照研究纳入了86例SLE患者，使用SLEDAI-2K评估疾病活动度。所有患者均进行了甲襞毛细血管镜检查。对所有患者检测抗尿苷1核糖核蛋白抗体。
抗尿苷1核糖核蛋白抗体与微出血呈显著负相关，抗双链DNA抗体阳性与微出血的存在呈显著正相关。此外，巨毛细血管、静脉丛可见性与较高的血沉（ESR）和C反应蛋白（CRP）之间存在显著正相关。雷诺现象与SLEDAI-2K、关节肿胀、关节压痛和抗双链DNA显著相关。多元线性回归分析显示，微出血和巨毛细血管是狼疮疾病活动度的最重要预测因素。
我们的研究结果突出了系统性红斑狼疮中微血管异常的普遍性，包括迂曲、交叉、伸长、微出血和巨毛细血管，强调了甲襞毛细血管镜检查在评估微循环和疾病活动度方面的重要性。此外，它增加了越来越多的证据，支持毛细血管异常，特别是微出血和巨毛细血管作为系统性红斑狼疮患者疾病活动度预测指标的预后价值。甲襞毛细血管镜检查可评估狼疮活动度，并有可能预测严重并发症的风险。
