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Nailfold videocapillaroscopy alterations in dermatomyositis, antisynthetase syndrome, overlap myositis, and immune-mediated necrotizing myopathy

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Abstract

Introduction/objectives

The aim of our study was to investigate possible differences in nailfold videocapillaroscopy (NVC) features between patients with dermatomyositis (DM), overlap myositis (OM), antisynthetase syndrome (ASS), and immune-mediated necrotizing myopathy (IMNM).

Methods

We performed a cross-sectional monocentric study. All patients with inflammatory myopathies (IMs) over a 6-month period were analyzed by NVC for giant and ramified capillaries, tortuosities, capillary density, disorganization, and scleroderma pattern. Clinical, biological, and pathological characteristics were retrospectively recorded. Patients were classified as having DM, OM, ASS, or IMNM for comparison. Patients were also compared with a group of patients with systemic sclerosis (SSc).

Results

NVC was analyzed in DM (n = 17), OM (n = 8), ASS (n = 12), and IMNM (n = 6). Vascular disorganization and avascular zones were observed only in DM (11.8%) and OM (62.5%). The percentage of patients with giant capillaries was higher in OM (n = 4/8) than in DM (n = 3/17) and absent in ASS and IMNM. Frequency of ramified capillaries, tortuosities, hemorrhages, or thrombosis was not different between subgroups. A scleroderma pattern was only observed in OM patients.

Conclusion

In this limited series of patients, we observed that DM and OM NVC abnormalities are different from ASS and IMNM. We could not determine NVC specific patterns associated with myositis-specific antibody subtypes of DM because of the small number of patients.

Key Points

• Nailfold videocapillaroscopy abnormalities are different in subgroups of inflammatory myopathies.

• Giant capillaries, disorganization, and major capillary loss are observed in overlap myositis and dermatomyositis but not in antisynthetase syndrome (ASS) or immune-mediated necrotizing myopathy.

• Nailfold videocapillaroscopy abnormalities in overlap myositis (with the exclusion of ASS) are close to systemic sclerosis.

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Acknowledgments

We thank Pr Nathalie Bardin for providing results for autoantibodies testing and Pr Christophe Chagnaud for magnetic resonance imaging in IMs patients.

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Authors and Affiliations

  1. Department of Internal Medicine AP-HM, Hopital Timone, 264 Rue Saint Pierre, 13385, Marseille cedex, France

    Caroline Soubrier, Julie Seguier, Marie-Pierre Di Costanzo, Mikael Ebbo, Emmanuelle Bernit, Estelle Jean, Véronique Veit, Laure Swiader, Jean-Marc Durand, Jean-Robert Harlé & Nicolas Schleinitz

  2. Aix-Marseille University, Marseille, France

    Julie Seguier, Mikael Ebbo, Shahram Attarian, Gilles Kaplanski, Jean-Marc Durand, Jean-Robert Harlé & Nicolas Schleinitz

  3. Referral Center for Neuromuscular Diseases and ALS AP-HM, Marseille, France

    Emmanuelle Salort-Campana, Shahram Attarian & André Maues De Paula

  4. Department of Internal Medicine AP-HM, Hopital Conception, Marseille, France

    Gilles Kaplanski

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  1. Caroline Soubrier
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Correspondence to Caroline Soubrier.

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The study was performed in accordance with the ethical standards of the Helsinki Declaration. According to the French law (no. 2004–806, August 9, 2004), and because the data were collected retrospectively and patient management was not modified, this study did not require a specific research ethics committee approval.

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Soubrier, C., Seguier, J., Di Costanzo, MP. et al. Nailfold videocapillaroscopy alterations in dermatomyositis, antisynthetase syndrome, overlap myositis, and immune-mediated necrotizing myopathy. Clin Rheumatol 38, 3451–3458 (2019). https://doi.org/10.1007/s10067-019-04710-2

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