Combination of Capillaroscopic and Ultrasonographic Evaluations in Systemic Sclerosis Results of a Cross-Sectional Study - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Arthritis Care & Research = Arthritis Care and Research Année : 2018

Combination of Capillaroscopic and Ultrasonographic Evaluations in Systemic Sclerosis Results of a Cross-Sectional Study

Résumé

Objective - To compare microvascular damages on nailfold capillaroscopy (NFC) with macrovascular manifestations evaluated by hand power Doppler ultrasonography (PDUS) in systemic sclerosis (SSc) patients, and to assess the associations of these damages with the main digital manifestations of the disease: digital ulcers, acroosteolysis, and calcinosis.

Methods - NFC, hand radiographs, and PDUS were systematically performed in 64 unselected SSc patients. PDUS evaluation with assessment of ulnar artery occlusion (UAO) and finger pulp blood flow (FPBF) were performed blinded for the results of radiographs and NFC.

Results - UAO and pathologic FPBF were associated with severe capillary loss (<4 capillaries/mm) on NFC (odds ratio [OR] 4.04 [95% confidence interval (95% CI) 1.23-13.29]; P < 0.05, and OR 3.38 [95% CI 1.03-11.05]; P < 0.05, respectively). Digital ulcer history was associated with UAO (OR 10.71 [95% CI 3.36-34.13]; P < 0.0001), pathologic FPBF (OR 7.67 [95% CI 2.52-23.28]; P < 0.0001), late NFC pattern (OR 6.33 [95% CI 2.03-19.68]; P = 0.001), and severe capillary loss (OR 8.52 [95% CI 2.15-33.78]; P = 0.001). Acroosteolysis was also associated with UAO (OR 15.83 [95% CI 3.95-63.54]; P < 0.0001), pathologic FPBF (OR 5.52 [95% CI 1.71-17.90]; P = 0.003), late NFC pattern (OR 6.86 [95% CI 2.18-21.53]; P = 0.001), and severe capillary loss (OR 7.20 [95% CI 2.16-24.02]; P = 0.001). Calcinosis on radiographs was associated with late NFC pattern (OR 5.41 [95% CI 1.82-16.12]; P = 0.002), severe capillary loss (OR 12.69 [95% CI 3.14-51.26]; P < 0.0001), and UAO (OR 3.19 [95% CI 1.14-8.92]; P = 0.025). Combination of UAO and severe capillary loss in the same patient was especially associated with digital ulcer history (OR 18.60 [95% CI 2.24-154.34]; P = 0.001) and acroosteolysis (OR 10.83 [95% CI 2.56-45.88]; P = 0.001).

Conclusion - Microvascular damages evaluated by NFC and macrovascular features like UAO assessed by PDUS show concordant associations with the main digital manifestations of the disease.

Fichier principal
Vignette du fichier
Lescoat et al. - Combination of capillaroscopic and ultrasonographi.pdf (555.67 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)
Loading...

Dates et versions

hal-01807751 , version 1 (15-06-2018)

Identifiants

Citer

Alain Lescoat, Guillaume Coiffier, Marine de Carlan, Catherine Droitcourt, Alice Ballerie, et al.. Combination of Capillaroscopic and Ultrasonographic Evaluations in Systemic Sclerosis Results of a Cross-Sectional Study. Arthritis Care & Research = Arthritis Care and Research, 2018, 70 (6), pp.938-943. ⟨10.1002/acr.23413⟩. ⟨hal-01807751⟩
173 Consultations
241 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More