AB0999 Finnish cohort of patients with raynaud's phenomenon-nailfold videokapillaroskopy findings and autoantibody values

Abstract

Objective: To investigate nailfold videocapillaroscopy (NVC) findings and autoantibody values in patients with Raynaud's phenomenon in a Finnish prospective multicentre study cohort. Method: We enrolled consecutive 160 patients with Raynaud's phenomenon who underwent NVC from September 2012 to April 2013. Nailfold capillaries of fingers II-V of both hands were examined using an optical probe videocapillaroscope with a ×200 lens. Images were analysed with Videocapt software. NVC findings were classified with qualitative scoring, and early, active, and late patterns were classified as 'scleroderma pattern'. Serum levels of antinuclear antibodies (ANAs), anti-topoisomerase I antibodies (anti-Scl-70), and anticentromere antibodies (ACAs) were analysed. Clinical and epidemiological features were reviewed. Results: The mean age of the patients was 50.4 years (SD 14.8, range 19-81 years), 79.4% were female, 15.6% were smokers, and three had diabetes. Reasons for performing NVC were: (i) assessment of disease activity in previously diagnosed scleroderma (n=26); (ii) differential diagnosis of Raynaud's phenomenon (n=98); and (iii) assessment of Raynaud's phenomenon in other rheumatic diseases (n=36). In group ii, mean age was 48.6 years (SD 14.6), 77.6% were female, and 17.3% were smokers. In this group, 25 (25.5%) were diagnosed with scleroderma during the study, 52 (53.1%) were diagnosed with primary Raynaud's phenomenon, and 21 (21.1%) with another rheumatic disease [mixed connective tissue disease n=2, Sjögren's syndrome n=3, SLE n=4, undifferentiated connective tissue disease n=8, and rheumatic arthritis n=4]. Among those patients who had a scleroderma diagnosis, only one (4%) had a normal NVC pattern, 19 (76.0%) had scleroderma pattern, and five (20.0%) had other non-specific changes. Four (16.0%) had low ANA, two (8.0%) had medium ANA, and 19 (76.0%) had high ANA titres. Eighteen (69.5%) had ACAs, and one (3.8%) had anti-Scl-70. Patients who had positive ACAs or anti-Scl-70 also had an NVC scleroderma pattern. Conclusion: The main reason for NVC in this cohort was differential diagnosis of Raynaud's phenomenon, and in most patients in the diagnostic group primary Raynaud's phenomenon was diagnosed. NVC is a useful method for differential diagnosis of Raynaud's phenomenon.