Nailfold videocapillaroscopy findings correlate with lung outcomes in idiopathic inflammatory myopathies-related interstitial lung disease
Por:
Santos, CS, Tandaipan, JL, Castillo, D, Codes-Mendez, H, Martínez-Martínez, L, Magallares, B, Moya-Alvarado, P, Mariscal, A, Park, HS, Díaz-Torné, C, Fernandez-Sanchez, SP, Bernardez, J, Corominas, H, Alvarez, ED, Castellví, I
Publicada:
1 dic 2025
Ahead of Print:
1 mar 2025
Resumen:
Objectives: Idiopathic inflammatory myopathies (IIM) are a diverse group of muscle diseases often complicated by interstitial lung disease (ILD), which significantly impacts morbidity and mortality. Krebs von den Lungen-6 (sKL-6) has been proposed as a biomarker for ILD severity. Nailfold videocapillaroscopy (NVC) detects microvascular changes, but its diagnostic and prognostic value in IIM remains unclear. This study aimed to assess the relationship between NVC abnormalities, sKL-6 levels, and pulmonary outcomes in IIM patients. Methods: A retrospective analysis was conducted in IIM patients from a reference center, comparing those with and without ILD. Data included epidemiological, clinical, and immunological features, pulmonary function tests, sKL-6 levels, and NVC findings. Statistical analyses included Spearman's rank correlation coefficient to assess the relationships between sKL-6 levels, pulmonary function tests, and NVC parameters. Multiple logistic regression modelling to identify to identify predictors of IIM-ILD. Results: Among 95 patients (34% male, median age 55.3 +/- 24 years, disease duration 6.8 +/- 7 years), ILD was associated with avascular zones (p= 0.004), capillary loss (p= 0.04), and microhemorrhages (p= 0.04). Negative correlations were observed between capillary loss and enlarged capillaries with %FVC (rs=-0.46, p= 0.001; rs=-0.57, p< 0.0001) and %DLCO (rs=-0.32, p= 0.04; rs=-0.23, p= 0.03). sKL-6 levels correlated positively with ILD (rs = 0.77, p= 0.0004), microhemorrhages (rs = 0.21, p= 0.04), and avascular areas (rs = 0.64, p= 0.03) and negatively with %FVC (rs=-0.47, p= 0.001) and %DLCO (rs=-0.59, p= 0.005). Predictors of ILD included male sex, respiratory symptoms, %FVC, %DLCO, sKL-6, anti-Jo1 positivity, and NVC abnormalities. Conclusions: NVC findings, sKL-6 levels, and autoantibodies are valuable in identifying and monitoring ILD in IIM, highlighting their role in early diagnosis and management.
Filiaciones:
Santos, CS:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Complejo Asistencial Univ, Leon, Spain
Tandaipan, JL:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Castillo, D:
Hosp Univ Santa Creu & St Pau, Barcelona, Spain
Codes-Mendez, H:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Martínez-Martínez, L:
Hosp Univ Santa Creu & St Pau, Barcelona, Spain
Magallares, B:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Moya-Alvarado, P:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Mariscal, A:
Hosp Univ Santa Creu & St Pau, Barcelona, Spain
Park, HS:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Díaz-Torné, C:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Fernandez-Sanchez, SP:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Bernardez, J:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Corominas, H:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
Alvarez, ED:
Complejo Asistencial Univ, Leon, Spain
Castellví, I:
Hosp Univ Santa Creu & St Pau, Rheumatol, Barcelona, Spain
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