AB1322 EULAR STANDARDISED NAIL-FOLD VIDEOCAPILLAROSCOPY FINDINGS IN TAKAYASU ARTERITIS - AN INDEPENDANT PARAMETER
Authors: N. Bhowmick, S. Jain, V. Dhir, R. Singh, M. Singhal
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Nail-fold capillaroscopy (NFC) is a non-invasive method for microcirculation assessment. In Scleroderma, NFC patterns help determine disease stages. In Vasculitides, the NFC findings are variable in different diseases and disease activity correlation is not always present. [1]. Previously studies have shown abnormalities in NFC in Takayasu Arteritis (TA) patients [2].This is the first study to be evaluating Nailfold capillaries in TA patients as per the standardised capillaroscopy evaluation chart by EULAR study group on Microcirculation [3]. <h3>Objectives:</h3> Primary- To document the changes on NFC in TA patients. Secondary - To determine if the NFC changes reflect small vessel dysfunction in TA by correlating- 1NFC parameters with the involvement of subclavian artery (SCA). 2NFC parameters with disease activity markers of TA. <h3>Methods:</h3> Ours was a single-centered, cross-sectional, observational study conducted at PGIMER, Chandigarh, a tertiary care hospital. Patients fulfilling the ACR 2022 classification criteria for TA underwent diagnostic CT Angiography or PET CT Angiography to assess arterial involvement. NFC using Opti-pix Optilia videocapillaroscope, and assessed with OptiPix capillaroscopy software was performed on both hands ring (4th) finger. Demographic data, peripheral pulses, ESR and CRP levels, current steroid dosage, duration of steroid use, and current immunosuppressant use were noted. Disease activity was evaluated using the ITAS A score. NVC findings, based on the EULAR study group's microcirculation consensus statement were noted and correlated with SCA involvement and disease activity parameters. <h3>Results:</h3> Our study included 35 TA patients. It was predominantly female population (85.7%) with a mean age of 29.9 years and disease onset age of 24.7 years. 31% had a disease duration of less than 2 years with a median duration of onset of symptoms of 3 years. Clinical examination revealed predominantly left-sided absent pulses. Mean ESR &amp; CRP was 35.4 mm and 5.5g/dl, and median ITAS A was 3. 34% had active TA (ITAS A &gt; 4). The most common type of Arterial involvement was Type V (60%), with the left SCA most affected (74.3%) followed by aortic arch (49%), descending thoracic aorta (45%) and right SCA (34.3%). 27 out of the 35 patients had unilateral or bilateral SCA involvement. Four NFC parameters were assessed: Density (Den), Dimension (Dim), Abnormal Morphology, and Hemorrhage. The abnormalities in each parameter are given in Table 1. 60% of patients had normal NFC findings in both hands with abnormality being detected commonly on the left hand. We found no correlation between the NFC den, dim, and morphologies of left and right hand. (Den p=.159; Dim p=.263; Morphology p=.258). Univariate regression analysis results showed that the SCA involvement did not predict the NVC Den, dim, or morphology on either hand. SCA involvement was also found to be not associated with any of the NFC abnormalities combined on either side. There was also no correlation between any of the NFC parameters with ITAS A scores, disease duration or duration of steroid intake. <h3>Conclusion:</h3> Our study shows 40% of TA patients have abnormal NFC findings with the most common being abnormal capillary density. The SCA involvement did not predict the NFC changes in any of the parameters and hence may reflect an independent small vessel dysfunction in the disease. There was no correlation with disease activity markers present. <h3>REFERENCES:</h3> [1] Movasat A, et al. Nailfold capillaroscopy in Behçet's disease, analysis of 128 patients. Clin Rheumatol. 2009 Feb 14;28(5):603–5. [2] Javinani A et al. Nailfold videocapillaroscopy changes in Takayasu arteritis and their association with disease activity and subclavian artery involvement. Microvasc Res. 2019;122(October 2018):1–5. Available from: https://doi.org/10.1016/j.mvr.2018.10.012. [3] Smith V et al. Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud's phenomenon and systemic sclerosis. Autoimmun Rev. 2020 Mar 1;19(3):102458. <b>Table 1.</b> Table showing the various abnormalities found in the NFC parameters <b>Table 2.</b> Table showing the p value of the various correlations- <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>