FRI0260 NAILFOLD VIDEOCAPILLAROSCOPY IS A USEFUL TOOL TO RECOGNIZE SYSTEMIC SCLEROSIS AND IDIOPATHIC INFLAMMATORY MYOPATHIES IN INTERSTITIAL LUNG DISEASE PATIENTS
Authors: G. Sambataro, D. Sambataro, F. Pignataro, N. Del Papa, M. Colaci, L. Malatino, A. Libra, F. Pino, S. E. Torrisi, S. Palmucci, L. Cavagna, C. Vanchieri
Journal: Annals of the Rheumatic Diseases (2020)

Background: Nailfold Videocapillaroscopy (NVC) is an essential tool for the assessment of Raynaud’s Phenomenon (RP) among the Scleroderma Spectrum Disorders (SSDs). Recently, NVC abnormalities have been associated with a diagnosis of Idiopathic Inflammatory Myopathies (IIMs), independently of the presence of RP (1). Moreover, both SSDs and IIMs are commonly associated with Interstitial Lung Disease (ILD), which is the main cause of mortality in these conditions. Objectives: To verify whether NVC may allow a better diagnostic classification in a cohort of patients with ILD followed by pulmonologists. Methods: 361 patients affected by ILD were prospectively enrolled in a 30-months observational study. All these patients were clinically evaluated by rheumatologists and pulmonologists together and performed general blood tests, autoantibody research, chest High-Resolution Computed Tomography and NVC. The latter was considered positive in the presence of avascular areas or giant capillaries, and also the presence of Bushy Capillaries (BCs) was recorded. Results: NVC was positive in 17.7% of ILD patients, and a third of these patients did not present RP. Patients with NVC abnormalities had a diagnosis of definite Connective Tissue Disease in 78.1% of cases. NVC resulted decisive in 25% of patients with a final diagnosis of Systemic Sclerosis according to the ACR/EULAR 2013 criteria. The presence of BCs and/or NVC+ in ILD patients with normal serum levels of muscular enzymes was associated with amyopathic IIM (BCs= OR 3.9, 95CI 1.05-14.38, p=0.04; NVC+= OR 5, 95CI 1.29-19.3 p=0.02; BCs and/or NVC+= OR 5.41 95CI 1.24-23.48 p=0.02), regardless the presence of RP. Conclusion: NVC proved to be a valid tool in the correct assessment of ILD patients secondary to SSDs and amyopathic IIMs. Therefore, it could be considered in the diagnostic evaluation of patients affected by ILD, regardless of the presence of RP. References: [1]Sebastiani M et al. Nailfold Capillaroscopy Characteristics of Antisynthetase Syndrome and possible clinical associations: results of a multicenter International Study. J Rheumatol 2019; 46: 279-284 Table 1. Comparison between ILD patients with and without NVC positivity. . Items NVC+ patients NVC- patients p Number 64 297 Mean Age (±SD) 61.4±13.3 67.8±9.8 0.001 Female% 65.6 49.1 0.01 RP% 68.7 17.1 &lt;0.0001 HRCT patterns% NSIP 51.5 36.8 0.02 OP 3.1 8 n.s. UIP-like 31.15 44.8 n.s. DIP 1.5 3.4 n.s. LIP 1.5 0.4 n.s. Indeterminate 10.9 6.7 n.s. Final Diagnosis% SSDs 45.3 1 &lt;0.0001 IIMs 25 6.4 &lt;0.0001 Other CTDs 6.2 13.5 n.s. IPAF 10.9 19.5 n.s. IPF 7.8 27.9 0.0007 Legend: DIP: Desquamative Interstitial Pneumonia; HRCT: High Resolution Computed Tomography; IIMs: Idiopathic Inflammatory Myopathies, Poly/dermatomyositis, antisynthetase syndrome; IPAF: Interstitial Pneumonia with Autoimmune Features; IPF: Idiopathic Pulmonary Fibrosis; LIP: Lymphocytic Interstitial Pneumonia; NSIP: Nonspecific Interstitial Pneumonia; OP: Organising Pneumonia; RP: Raynaud’s Phenomenon; SSDs: Scleroderma Spectrum Disorders, Systemic Sclerosis + Mixed Connective Tissue Disease; UIP: Usual Interstitial Pneumonia. Disclosure of Interests: Gianluca Sambataro: None declared, Domenico Sambataro: None declared, Francesca Pignataro: None declared, Nicoletta Del Papa: None declared, Michele Colaci: None declared, Lorenzo Malatino: None declared, Alessandro Libra: None declared, Fabio Pino: None declared, Sebastiano Emanuele Torrisi Speakers bureau: Boehringer Ingelheim; F. Hoffmann-La Roche Ltd., Stefano Palmucci Consultant of: Boehringer Ingelheim, Speakers bureau: Boehringer Ingelheim, Delphi International Srl, and F. Hoffmann-La Roche Ltd., Lorenzo Cavagna: None declared, Carlo Vanchieri Grant/research support from: F. Hoffmann-La Roche Ltd., Consultant of: AstraZeneca, Boehringer Ingelheim, Chiesi, F. Hoffmann-La Roche Ltd., and Menarini, Speakers bureau: AstraZeneca, Boehringer Ingelheim, Chiesi, F. Hoffmann-La Roche Ltd., and Menarini