Nailfold video capillaroscopy in patients with rheumatoid arthritis- interstitial lung disease

Abstract Background Nailfold video capillaroscopy (NVC) has emerged as a non-invasive, inexpensive, and easily applicable technique for studying peripheral microangiopathy. It is reasonable that direct visualization of human microcirculation could provide valuable information regarding vascular health at a preclinical level. Under this prism, NVC examination might emerge as an instrumental modality with a complementary role in the early detection of microvascular pathology associated with RA and its extra-articular manifestations. Our study aimed to assess the pathological abnormalities in NVC in RA patients and study its possible relation with interstitial lung disease (ILD). Methodology Thirty RA patients were divided into two groups: 15 patients without ILD and 15 patients with ILD. These patients underwent detailed history, thorough clinical examination, laboratory investigations, chest high-resolution CT (HRCT), and NVC. Results Mean capillary density was significantly reduced in RA-ILD patients (6.00 ± 1.2 vs. 7.6 ± 1.18 capillary/mm). The percentage of patients with severe tortuosity score was significantly higher in RA-ILD patients (86.7% vs. 13.3%) and the percentage of patients with abnormal shapes was significantly higher in RA-ILD patients (66.7% vs. 20.0%). Conclusion NVC had more abnormalities in patients with RA-ILD than those without ILD regarding capillary density, tortuosity and presence of abnormal shapes. No imaging modality can fully replace the comprehensive information provided by chest HRCT, which remains the gold standard for assessing pulmonary fibrosis. Capillaroscopy in ILD presents itself as a useful, non-invasive, cost-effective, accessible, and radiation-free adjunctive tool for the prediction of ILD in RA patients. Further studies are essential for generalizing these results.