[Morphological alterations in nailfold capillaroscopy and the clinical picture of vascular involvement in autoimmune diseases: systemic lupus erythematosus and type 1 diabetes].

Systemic lupus erythematosus (SLE) and type 1 diabetes mellitus (DM) belong to the group of autoimmune diseases presenting with a wide range of organ manifestations. Microvascular abnormalities seem to play a crucial role in the development of persistent multi-organ complications in both diseases. The aim of this study was to determine the relationship between microvascular changes examined with nailfold capillaroscopy and organ involvement.
We eurolled 76 SLE patients, 106 patients with type 1 diabetes, and 40 healthy controls.
Morphological changes were observed with nailfold capillaroscopy in 86 (81%) diabetics and in 70 (92.1%) SLE patients. Severe capillaroscopic changes were disclosed in 32 out of 54 (59%) diabetic patients with microangiopathy and in only 7 out of 52 (13%) patients without microangiopathy. In the SLE group, severe capillaroscopic abnormalities were found in 18 out of 34 (52.9%) patients with organ involvement and in 9 out of 42 (21.4%) patients without organ involvement. The capillaroscopic score was significantly higher in diabetic patients with microangiopathic complications in comparison to patients without microangiopathy (p < 0.001). Moreover, diabetic patients with advanced microvascular changes had longer disease durations than patients with mild abnormalities. A similar comparison between SLE patients with and without systemic manifestations showed significantly higher capillaroscopic scores in the group with organ involvement (p < 0.001). Furthermore, a positive correlation between capillaroscopic score and disease activity was observed in SLE patients (p < 0.01).
Our findings suggest that abnormalities in nailfold capillaroscopy reflect the extent of microvascular involvement and are associated with organ involvement in SLE and diabetes.