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AB1196 Role of capillaroscopy in the study of the raynaud phenomenon in conditions of clinical practice

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Background The Raynaud phenomenon (RP) is very common throughout the world, especially in cold climates, affecting approximately 3%–5% of the population. Most RPs are primary. The risk of the onset… Click to show full abstract

Background The Raynaud phenomenon (RP) is very common throughout the world, especially in cold climates, affecting approximately 3%–5% of the population. Most RPs are primary. The risk of the onset of autoimmune disease associated with RP (ADRP) is between 6% and 12%, and the diagnosis is usually made within 2 years of its onset. Capillaroscopy is a simple, innocuous and inexpensive technique that is very useful in the study of RP Objectives The primary goal was to evaluate the capillaroscopic findings in patients with RF as the only symptom and establish their relationship between the subsequent development of ADRF. Methods We conducted an observational, descriptive, cross-sectional study of a random sample of 98 patients with RP as the main manifestation, selected from within the capillaroscopy consult of our Unit. The capillaroscope used was a stereomicroscope (Stereoscope), with a triocular head, zoom range from 1x to 4x magnification, with cold light illuminator and high resolution ocular camcorder. Periungual capillaroscopy was performed in 3rd, 4th and 5thfinger of the right and left hands in each patient and always by the same rheumatologist. We described the sociodemographic variables of patients, and analytical results of the antinuclear antibodies (ANA). After an initial statistical exploration of the data, the same are described. The quantitative variables are expressed as means and standard deviations and if the distributions are asymmetric with medians and quartiles. The qualitative variables with percentages. To assess the validity of capillaroscopy as a diagnostic test, we determined the sensitivity, specificity, and positive and negative predictive value of the test. Results 73.5% were women, with an average age of 45.7 years. The median time of evolution of the RP until the capillaroscopy was 2.5 years. 76% of the patients were ANA negative. The evaluation of the predictive capacity of capillaroscopy for the development of EARP yields the following results:Abstract AB1196 – Table 1 Sensibility 83,3%62,6–95,2 Specificity 78%66,8–86,9 Predictive positive value 34,1%(24,5–45,3 Predictive negative value 97,1%(93,3–98,8 When analysing the relationship between the presence of ANA and the association with ADRF we found that it was independent (p=0.002) of the result of capillaroscopy, being the risk of developing the disease in a patient with positive ANA 8.5 times higher than in an ANA negative patient. Conclusions Capillaroscopy in patients with RP has a high predcitive negative value, which allows us to estimated, with high reliability, the association of this phenomenon with autoimmune disease in patients with normal capillaroscopic patterns. Given the results of our study, capillaroscopy should be protocol in the RP study Disclosure of Interest None declared

Keywords: raynaud phenomenon; capillaroscopy; value; study

Journal Title: Annals of the Rheumatic Diseases
Year Published: 2018

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