Nailfold capillaroscopic profile of Connective Tissue Disease - related Interstitial Lung disease at a tertiary care center in North India

Kunal Kishore; Vivek Vasdev; Arjun MN

Volume : IX, Issue : I, January - 2020

Nailfold capillaroscopic profile of Connective Tissue Disease - related Interstitial Lung disease at a tertiary care center in North India

Kunal Kishore, Vivek Vasdev, Arjun Mn

Abstract :

Background: Lung involvement especially interstitial lung disease (ILD), can be the first manifestation of an underlying connective tissue disorder (CTD), at times preceding the extra–pulmonary features by many years. Nailfold capillaroscopy is an important tool, which helps us in early recognition of microvascular changes in patients with ILD. Methods: This is a single center cross–sectional observational study of 50 patients with CTD–ILD. They were classified into 4 main groups : idiopathic inflammatory myositis associated ILD (IIM –ILD), mixed connective tissue disorder associated ILD (MCTD–ILD), primary Sjogren Syndrome associated ILD (pSS–ILD) and Systemic sclerosis associated ILD ( SSc–ILD). They were also classified according to radiologic lung patterns on HRCT chest, as UIP pattern or NSIP pattern. Nailfold capillaroscopy (NFC) was performed for all patients at room temperature and various NFC parameters were recorded and analysed using the Kruskal–Wallis non–parametric test and chi–square test wherever applicable. Results: The mean age of patients was 43.6 � 14.3 years. Mean duration of the disease was 58.4 � 20.2 months. There were 32 patients with the UIP pattern and 18 patients with the NSIP pattern of ILD . The commonest NFC abnormalities were megacapillaries and microhemorrhages (20% and 22% respectively). The difference between the mean capillary density was not significant between subgroups (p= 0.337). This was true for other NFC parameters too. Conclusion: This study is one of the first in describing the nailfold capillaroscopic changes in patients of CTD–ILD in the Indian subcontinent.