FRI0650 A NAILFOLD CAPILLAROSCOPY STUDY IN A COHORT OF PATIENTS WITH ANTI-PHOSPHOLIPID ANTIBODIES
Authors: Massimiliano Vasile, Katia Stefanantoni, Fulvia Ceccarelli, Elena Marafioti, Fabrizio Conti, Valeria Riccieri, Guido Valesini
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Nailfold capillaroscopy (NC) is a simple and non-invasive diagnostic technique, able to investigate microvascular features. In subjects with anti-phospholipid autoantibodies (aPL) many different endothelial abnormalities have been described. <h3>Objectives</h3> We aimed to investigate the role of NC in aPL positive (aPL+) subjects, highlighting the main microvascular alterations, detected by NC. <h3>Methods</h3> We enrolled 39 patients with primary anti-phospholipids syndrome (pAPS) (32 females, mean age 43 years, mean disease duration 7 years), 47 patients with secondary anti-phospholipis syndrome (sAPS) due to Systemic Lupus Erythematosus (36 females, mean age 44 years, mean disease duration 15.5 years) and 17 aPL+ subjects without any autoimmune disease, defined as aPL carriers (16 females, mean age 42 years). All subjects underwent clinical and laboratory evaluations as well as NC with both characterization of morfological parameters and attribution of a semiquantitative score. <h3>Results</h3> The main NC findings were: morphological alterations (tortuous, bushy and/or ramified capillary) in 100% patients with pAPS, in 77% sAPS patients and in 88% aPL carriers; microhaemorragies in 56% pAPS patients, in 49% sAPS patients and 24% aPL carriers; enlarged hairpins in 23%, 41% and 18% subjects with pAPS, sAPS and aPL carriers respectively. In 6.3% sAPS patients, an early scleroderma pattern was detected. A NC semiquantitative score 1 was found in 58.9% pAPS patients, in 57.4% sAPS patients and in 70.5% aPL carriers. Among those cases with abnormal NC findings, we found that a higher NC score (&gt;2) was significantly more frequent in pAPS (21.7%) and sAPS (22.2%) patients respect to aPL carrier cases (8.3%) (p&lt;0,005). We also found, among the main cardiovascular risk factors, that a higher score (1) was significantly associated with the presence of diabetes mellitus in pAPS patients (p&lt; 0,0001) and with arterial hypertension (p&lt;0,0004) and dyslipidemia (p&lt;0,0007) both in sAPS patients and aPL carriers. <h3>Conclusion</h3> Our findings show that some NC aspecific abnormalities are more frequently found in aPL positive subjects, mainly in pAPS and sAPS ones. Altough not specific, such NC features seem to be associated with the presence of vascular risk factors. Thus NC could be regarded as a useful tool in order to evaluate microcirculation in aPL positive cases. <h3>References</h3> [1] Tavakol MEet al, Biomed Res Int2015; 2015: 974530. [2] Maricq HRet al, Arthritis Rheum1980; 23: 183 – 188. [3] Vaz JLPet al, Rheumatology2004;43:1025–7. [4] Sulli A, J Rheum2000;27:1574–6. [5] Aslanidis S, Clin Exp Rheum2011;29:307–9. <h3>Disclosure of Interests</h3> massimiliano vasile: None declared, Katia Stefanantoni Consultant for: Only 1 scientific advice for Italfarmaco in 2016, Fulvia Ceccarelli: None declared, Elena Marafioti: None declared, fabrizio conti: None declared, Valeria Riccieri: None declared, Guido Valesini: None declared