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Nailfold capillaroscopy changes associated with anti-RNP antibodies in systemic lupus erythematosus

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Abstract

Anti-U1RNP antibody is associated with distinct organ involvement in patients with systemic lupus erythematosus (SLE). Nailfold capillaroscopy (NFC) allows non-invasive assessment of microvascular abnormalities in several connective tissue diseases. The objective of this study is to determine the association of anti-U1RNP antibody with microvascular changes by NFC in RNP-positive SLE patients in comparison with RNP-negative SLE patients (negative disease controls) and mixed connective tissue disease (MCTD) cases (positive disease controls). NFC examination was performed in consecutive patients with SLE with or without anti-U1RNP positivity. MCTD patients were recruited as disease controls. Abnormalities noted in the three groups were compared using non-parametric tests. Ordinal logistic or linear regression was used wherever applicable. 81 patients were studied, of whom 28 were diagnosed as RNP-positive SLE (age 30.0 ± 10.37; 26 females), 26 were RNP-negative SLE (age 29.42 ± 9.20; 25 females) and 27 had MCTD (age36.5 ± 9.70; 25 females). RNP-positive SLE patients had more frequent giant capillaries, enlarged capillaries and ramified capillaries as compared to RNP-negative SLE (p = 0.05, < 0.01 and 0.03, respectively). The capillary density was lower in patients with MCTD as compared with patients with RNP-positive SLE (5.11 ± 1.69/mm vs 7.25 ± 1.38/ mm, p < 0.01) and RNP-negative SLE (8.92 ± 1.13/mm, p < 0.01). The reduction in capillary density was less severe in patients with RNP-negative SLE as compared with RNP-positive SLE (OR = 0.1058 [95% CI = 0.02–0.546], p < 0.01) which was independent of the presence of Raynaud’s phenomenon, interstitial lung disease and disease duration. Presence of anti-U1RNP antibody is associated with notable patterns of microvascular abnormalities in SLE. These NFC abnormalities are noted more profoundly in patients with MCTD and are less marked in RNP-negative SLE patients.

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Data availability

The data that support the findings of this study are available on request from the 1st author and the corresponding author.

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Funding

This work was supported by the intramural grant to Pramod Prahlad Chebbi from Christian Medical College Vellore 

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Authors and Affiliations

  1. Departments of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India

    Pramod Prahlad Chebbi, Ruchika Goel, J. Ramya & Debashish Danda

  2. Departments of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India

    M. Gowri

  3. Division of Musculoskeletal and Dermatological Sciences, Manchester Academic Health Science Centre, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester, M13 9PT, UK

    ArianeL Herrick

  4. Department of Rheumatology, SDM College of Medical Sciences and Hospital, SDM University, Dharwad, Karnataka, India

    Pramod Prahlad Chebbi

  5. Department of Clinical Immunology and Rheumatology, St. John’s Medical College, Bengaluru, Karnataka, India

    J. Ramya

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  1. Pramod Prahlad Chebbi
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Correspondence to Ruchika Goel.

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Chebbi, P.P., Goel, R., Ramya, J. et al. Nailfold capillaroscopy changes associated with anti-RNP antibodies in systemic lupus erythematosus. Rheumatol Int 42, 1355–1361 (2022). https://doi.org/10.1007/s00296-021-04894-4

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  • DOI: https://doi.org/10.1007/s00296-021-04894-4

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