Re-evaluation of nailfold capillaroscopy in discriminating primary from secondary Raynaud's phenomenon and in predicting systemic sclerosis: a randomised observational prospective cohort study.

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  • Additional Information
    • Source:
      Publisher: Taylor & Francis Country of Publication: England NLM ID: 101271248 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-8409 (Electronic) Linking ISSN: 1744666X NLM ISO Abbreviation: Expert Rev Clin Immunol Subsets: MEDLINE
    • Publication Information:
      Publication: 2015- : Abingdon, Oxford : Taylor & Francis
      Original Publication: London, UK : Future Drugs Ltd., 2005-
    • Subject Terms:
      Raynaud Disease*/diagnosis ; Microscopic Angioscopy*/methods ; Scleroderma, Systemic*/diagnosis; Humans ; Female ; Middle Aged ; Male ; Prospective Studies ; Adult ; Prognosis ; Cohort Studies ; Aged ; Diagnosis, Differential ; Capillaries/diagnostic imaging ; Capillaries/pathology ; Nails/blood supply ; Nails/pathology ; Predictive Value of Tests
    • Abstract:
      Background: Primary Raynaud's phenomenon (pRP) is difficult to distinguish from secondary (sRP). Although nailfold capillaroscopy (NFC) may detect early alterations, no universal criteria yet discriminate between pRP from sRP.
      Objectives: To create and validate two NFC scores that could distinguish pRP from sRP and that could predict systemic sclerosis (SSc), respectively.
      Methods: We performed NFC on two separate cohorts with isolated RP, and recorded number of capillaries per field, enlarged/giant capillaries, crossed/bizarre patterns, microhemorrhages, neoangiogenesis, rarefaction, edema, blood flow velocity, stasis. By multivariate regression analysis, we evaluated the adjusted prognostic role of these features in a derivation cohort of 656 patients. Results were used to construct algorithm-based prognostic scores (A and B). These scores were then tested on a confirmation cohort of 219 patients.
      Results: Score A was unable to discriminate sRP from pRP (low negative predictive values with high positive predictive values for any cut-point); score B was unable to discriminate progression to SSc or a SSc-spectrum disorder (low positive predictive values with high negative predictive values for lower cut-points).
      Conclusion: NFC patterns, believed as specific, showed low discriminatory power and on their own are unable to reliably discriminate sRP from pRP or predict evolution to SSc.
    • Contributed Indexing:
      Keywords: Nailfold capillaroscopy; connective tissue disease; primary Raynaud’s phenomenon; raynaud’s disease; secondary Raynaud’s phenomenon; systemic sclerosis; videocapillaroscopy
    • Publication Date:
      Date Created: 20240311 Date Completed: 20240516 Latest Revision: 20240717
    • Publication Date:
      20240717
    • Accession Number:
      10.1080/1744666X.2024.2313642
    • Accession Number:
      38465507