AB0675 DECREASED CAPILLARY DENSITY IS ASSOCIATED WITH DECREASED HAND MOBILITY IN SYSTEMIC SCLEROSIS
Authors: Gabriella Nagy, Antonietta Kovács, Dalma Komjati, Renata Szijártó, Tunde Minier, Gabor Kumanovics, László Czirják, Cecília Varjú
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Nailfold videocapillaroscopy (NVC) is a simple method to evaluate capillary density and morphology. Systemic sclerosis (SSc) is characterized with decreased hand mobility and joint contractures evolving in hands in early disease stage. Movement ability (MA) of hands can be measured with different methods including Hand Mobility index in Scleroderma (HAMIS), hand anatomic index (HAI), delta finger-to-palm index (ΔFTP), and number of joints with decreased range of motion (joint contractures-JC). <h3>Objectives</h3> To examine correlation between capillary density and MA of hands in patients with SSc. <h3>Methods</h3> 136 patients with SSc underwent detailed examination of MA and capillary density measured with videocapillaroscop. 70 patients had limited cutaneous SSc (lcSSc) and 66 had diffuse cutaneous SSc (dcSSc). 48 patients had ≤5 years of disease duration (early SSc) and 88 patients had disease duration&gt;5 years (late SSc) calculated from the first non-Raynaud symptoms. <h3>Results</h3> DcSSc patients had significantly higher HAMIS score than lcSSc patients (4.5/1.5;6.5/ vs. 2/0.5;4.5/; p&lt;0.01). HAMIS score showed negative correlation with capillary density in the entire cohort (rho: -0.269, p&lt;0.01) and in dcSSc patients (rho:-0.487; p&lt;0.0001), but not in lcSSc ones. HAI showed a significantly higher value in lcSSc patients than in dcSSc patients (3.79/3.18;4.39/vs.3.19/2.64;3.76/, p&lt;0.01). Significant positive correlation between HAI and capillary density was found in dcSSc patients (rho: 0.377, p&lt;0.01). DcSSc patients showed significantly lower ΔFTP value than lcSSc patients (73.88/65.63;87.00/ vs. 82.81/73.63;90.5/; p&lt;0.05). Positive correlation was found between capillary density and ΔFTP in the entire cohort, in dcSSc patients even if dcSSc was examined separately as early dcSSc and late dcSSc. No significant correlation was found between capillary density and ΔFTP in lcSSc patients. The number of JC was significantly higher in dcSSc patients than in lcSSc patients (16/0;28/ vs. 0/0;11/; p&lt;0.01), and no statistically significant difference was found between early SSc patients and late SSc patients. Strong negative correlation was found between JC count and capillary density in the entire cohort (rho -0.376; p&lt;0.0001), in dcSSc patients (rho -0.501; p&lt;0.0001), in early SSc patients (rho-0.583; p&lt;0.0001) and late SSc patients (rho -0,262 p&lt;0.05), but not in lcSSc patients. <h3>Conclusion</h3> Decreased capillary density correlated with decreased hand mobility and higher number of JCs. Tissue ischemia may play role in the development of joint contractures and it might be a contributing factor to decreased hand mobility impairment in SSc. <h3>References</h3> [1] Torok KS, Baker NA, Lucas M, et al. Reliability and validity of the delta finger-to-palm (FTP), a new measure of finger range of motion in systemic sclerosis. Clin Exp Rheumatol. 2010;28(2)(Suppl58):S28-S36. [2] Sandqvist G, Nilsson JA, Wuttge DM, Hesselstrand R. Development of a modified hand mobility in scleroderma (HAMIS) test and its potential as an outcome measure in systemic sclerosis. J Rheumatol. 2014;41(11):2186-2192. [3] Sebastiani M, Manfredi a, Colaci M,et al. Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Arthritis Rheum2009; 61: 688-694 [4] Ruaro B, Sulli a, Smith V, et al. Advances in nailfold capillaroscopic analysis in systemic sclerosis. JSRD2018; 3: 122 –131. <h3>Disclosure of interests</h3> None declared