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Rheumatology Advance Access published online on June 8, 2004
Rheumatology, doi:10.1093/rheumatology/keh233
Rheumatology © British Society for Rheumatology 2004; all rights reserved
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Received November 4, 2003
Accepted April 8, 2004

Original Papers

Nailfold videocapillaroscopy in primary antiphospholipid syndrome (PAPS)

J. L. P. Vaz 1, M. A. A. Dancour 1, D. A. Bottino 1*, E. Bouskela 1

1 Laboratory for Research in Microcirculation, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil

* To whom correspondence should be addressed. E-mail: bottino{at}netfly.com.br.


  Abstract

Objectives. To evaluate microcirculatory changes (functional and morphological) in primary antiphospholipid syndrome (PAPS) patients.

Methods. Thirty-one patients were examined using nailfold videocapillaroscopy (18 PAPS patients and 13 healthy subjects). The patients were subdivided into two subgroups, with lupus anticoagulant (n = 8) and with anticardiolipin (n = 10) antibodies. Capillary morphology was determined; diameters (µm) and functional capillary density (FCD, number capillaries/mm2) were measured in control conditions. Blood flow velocity (CBFV, mm/s) was also evaluated at rest and after release of 60 s arterial occlusion.

Results. The percentage of subjects with at least one morphological alteration in the observed capillaries was 77.8% for patients and 21.3% for healthy subjects. Capillary diameters (µm) [afferent (AD), apical (APD) and efferent (ED)] were significantly smaller (mean ± s.d.: AD-PAPS, 7.4 ± 2.1; control, 9.1 ± 2.6, P = 0.063; APD-PAPS, 11.6 ± 2.3; control, 14.4 ± 3.8, P = 0.015; ED-PAPS, 8.4 ± 2.0; control, 10.9 ± 3.2, P = 0.011) in PAPS patients compared with controls. FCD (PAPS, 8.5 ± 3.2; control, 8.3 ± 2.9, P ± 0.862), mean resting CBFV (PAPS, 0.73 ± 0.31; control, 0.88 ± 0.41, P = 0.278), mean peak CBFV after occlusion (PAPS, 1.07 ± 0.52; control, 1.59 ± 0.91, P = 0.063) and mean time (s) to reach it (PAPS, 5.2 ± 1.7; control, 4.6 ± 1.8, P = 0.101) were not statistically different between the two groups.

Conclusion. Our results suggest that nailfold capillary morphology is altered in patients with PAPS, but these changes could not be correlated to impairment of functional parameters.

KEY WORDS: Antiphospholipid syndrome, Videocapillaroscopy, Reactive hyperaemia, Nailfold capillaries.


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