Nailfold capillaroscopy findings of interstitial pneumonia with autoimmune features

Background/Aims We evaluated nailfold capillaroscopy (NFC) of interstitial pneumonia with autoimmune features (IPAF) and compared it with that of patients with connective tissue disease-interstitial lung disease (CTD-ILD) and idiopathic interstitial pneumonia (IIP). Methods Patients with newly diagnosed as ILD were evaluated using NFC. Baseline demographic, clinical, serological, and high-resolution CT findings were collected. NFC was semi-quantitatively scored with six domains ranging from 0 to 18. In addition, the overall patterns (scleroderma/non-scleroderma patterns) were determined. Results A total of 81 patients (31 with CTD-ILD, 18 with IPAF, and 32 with IIP) were included. The non-specific interstitial pneumonia pattern was the most common ILD pattern in the CTD-ILD and IPAF groups, whereas the usual interstitial pneumonia pattern was the most common in the IIP group. The semi-quantitative score of the CTD-ILD group was higher than that of the IPAF or IIP groups (5.8 vs 4.2 vs 3.0, p < 0.001, respectively). Giant capillaries and haemorrhages were more frequently present in the CTD-ILD and IPAF groups than in the IIP group. A scleroderma pattern was present in 27.8% of the IPAF group, whereas none of the IIP patients showed a scleroderma pattern. Conclusions NFC findings may be useful in classifying patients with ILD into CTD-ILD/IPAF/IIP.

[1]  D. Furst,et al.  Progression of patients with Raynaud's phenomenon to systemic sclerosis: a five-year analysis of the European Scleroderma Trial and Research group multicentre, longitudinal registry study for Very Early Diagnosis of Systemic Sclerosis (VEDOSS). , 2021, The Lancet. Rheumatology.

[2]  E. Lee,et al.  Association of Serum Biomarkers With Pulmonary Involvement of Rheumatoid Arthritis Interstitial Lung Disease: From KORAIL Cohort Baseline Data , 2021, Journal of rheumatic diseases.

[3]  Neil McGill,et al.  Nailfold capillaroscopy by smartphone-dermatoscope for connective tissue disease diagnosis in interstitial lung disease: a prospective observational study , 2021, ERJ open research.

[4]  Wei Zhang,et al.  Interstitial Lung Disease in Connective Tissue Disease: A Common Lesion With Heterogeneous Mechanisms and Treatment Considerations , 2021, Frontiers in Immunology.

[5]  H. Min,et al.  Recent advances in the diagnosis and management of interstitial pneumonia with autoimmune features: the perspective of rheumatologists , 2020, The Korean journal of internal medicine.

[6]  C. Vancheri,et al.  Nailfold Videocapillaroscopy Is a Useful Tool to Recognize Definite Forms of Systemic Sclerosis and Idiopathic Inflammatory Myositis in Interstitial Lung Disease Patients , 2020, Diagnostics.

[7]  Jae Ho Lee,et al.  Efficacy of lower dose pirfenidone for idiopathic pulmonary fibrosis in real practice: a retrospective cohort study , 2020, The Korean journal of internal medicine.

[8]  Yang Gao,et al.  Treatment of the Connective Tissue Disease-Related Interstitial Lung Diseases: A Narrative Review. , 2020, Mayo Clinic proceedings.

[9]  F. Meloni,et al.  Multidisciplinary Approach in the Early Detection of Undiagnosed Connective Tissue Diseases in Patients With Interstitial Lung Disease: A Retrospective Cohort Study , 2020, Frontiers in Medicine.

[10]  C. Vancheri,et al.  The Morphological Domain Does Not Affect the Rate of Progression to Defined Autoimmune Diseases in Patients With Interstitial Pneumonia With Autoimmune Features. , 2020, Chest.

[11]  S. Cerri,et al.  Interstitial pneumonia with autoimmune features: A single center prospective follow-up study. , 2019, Autoimmunity reviews.

[12]  V. Cottin,et al.  Interstitial Pneumonia With Autoimmune Features (IPAF) , 2019, Front. Med..

[13]  V. Bernardino,et al.  Nailfold capillaroscopy and autoimmune connective tissue diseases in patients from a Portuguese nailfold capillaroscopy clinic , 2019, Rheumatology International.

[14]  D. Gladman,et al.  2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus , 2019, Arthritis & rheumatology.

[15]  Jeong Uk Lim,et al.  Interstitial pneumonia with autoimmune features show better survival and less exacerbations compared to idiopathic pulmonary fibrosis , 2019, BMC Pulmonary Medicine.

[16]  Jong Sun Park,et al.  Presentation, diagnosis and clinical course of the spectrum of progressive-fibrosing interstitial lung diseases , 2018, European Respiratory Review.

[17]  J. Pauling,et al.  Does nailfold capillaroscopy help predict future outcomes in systemic sclerosis? A systematic literature review. , 2018, Seminars in arthritis and rheumatism.

[18]  F. Ingegnoli,et al.  Outcomes, rates and predictors of transition of isolated Raynaud's phenomenon: a systematic review and meta-analysis. , 2017, Swiss medical weekly.

[19]  P. Emery,et al.  Absence of Scleroderma pattern at nail fold capillaroscopy valuable in the exclusion of Scleroderma in unselected patients with Raynaud’s Phenomenon , 2016, BMC Musculoskeletal Disorders.

[20]  M. Mayes,et al.  2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative , 2013, Annals of the rheumatic diseases.

[21]  D. Symmons,et al.  2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. , 2010, Arthritis and rheumatism.

[22]  M. Cutolo,et al.  Scoring the nailfold microvascular changes during the capillaroscopic analysis in systemic sclerosis patients , 2007, Annals of the rheumatic diseases.

[23]  S. Bombardieri,et al.  Undifferentiated connective tissue diseases (UCTD): a review of the literature and a proposal for preliminary classification criteria. , 1999, Clinical and experimental rheumatology.

[24]  I. Noth,et al.  “ERS/ATS Task Force onUndifferentiated Forms of CTD-ILD”. An official European RespiratorySociety/American Thoracic Society research statement: interstitial pneumonia withautoimmunefeatures , 2015 .