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Vol. 21. Issue 1.
(January 2025)
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Vol. 21. Issue 1.
(January 2025)
Original article
Nailfold capillaroscopic changes in patients with glomerular diseases
Cambios capilaroscópicos del pliegue ungueal en pacientes con enfermedades glomerulares
Hend Adela, Ahmed A. Eldeeba, Fatma Hamdyb,&#¿;
Corresponding author
fatmahamdyfh88@mans.edu.eg

Corresponding author.
a Internal Medicine (Nephrology), Mansoura University, Mansoura, Egypt
b Internal Medicine (Rheumatology and Immunology), Mansoura University, Mansoura, Egypt
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Tables (6)
Table 1. Difference in capillaroscopic characteristics between patients with primary glomerular diseases and the healthy control group.
Table 2. Difference in sociodemographic, clinical and laboratory characteristics between patients with primary glomerulonephritis and patients with lupus nephritis.
Table 3. Difference in capillaroscopic characters between patients with primary glomerulonephritis and patients with lupus nephritis.
Table 4. Difference in capillaroscopy between patients with different types of primary glomerulonephritis.
Table 5. Difference in capillaroscopy between patients with different classes of lupus nephritis.
Table 6. Correlation between proteinuria, capillaroscopic parameters and serum creatinine.
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Abstract
Introduction and objectives

Glomerulonephritis is a heterogenous group of diseases which is diagnosed mainly by renal biopsy. This study aims to assess nailfold capillaroscopic changes in patients with glomerular diseases.

Patients and methods

This study was conducted on 50 patients with glomerular disease confirmed by renal biopsy and 50 age and sex matched healthy controls. Clinical, laboratory evaluation and nailfold capillaroscopic examination were done for all participants.

Results

Lupus nephritis was the most common pathological type among glomerulonephritis group [17 (34%)], followed by focal segmental glomerulosclerosis [9 (18%)]. Tortuous capillaries were significantly higher in patients with primary glomerular diseases compared to healthy persons (92.9% vs 58%, P<0.001). The diameter was significantly lower in patients with primary glomerular diseases compared to healthy control group (15.6μm vs 18.9μm, P=0.001). Subpapillary venous plexus (28.6% vs 6%, P=0.02) and capillary microhemorrhage (32% vs 0%, P<0.001) were significantly more frequent in patients with primary glomerular diseases compared to the control group. Patients with lupus nephritis had higher capillary diameter (19.5 vs 15.6μm, P=0.02), width (55.6 vs 44μm, P=0.003) and microhemorrhage (64.7% vs 32%, P=0.03) compared to patients with primary glomerulonephritis. There was a statistically significant difference as regard diameter (P=0.005) and length (P=0.02) between different classes of lupus nephritis.

Conclusion

More tortious capillaries and lower capillary diameter were found in patients with primary glomerular disease compared to healthy persons. Lupus nephritis patients had more dilated capillaries and more capillary microhemorrhage compared to primary glomerulonephritis patients.

Keywords:
Glomerulonephritis
Nailfold capillaroscopy
Lupus nephritis
Glomerular diseases
Abbreviations:
CKD
CRP
DM
ESR
ESRD
FSGS
GN
NFC
RA
SLE
Resumen
Introducción y objetivos

Las glomerulonefritis son un grupo heterogéneo de enfermedades que se diagnostican principalmente mediante biopsia renal. Este estudio tiene como objetivo evaluar los cambios capilaroscópicos del pliegue ungueal en pacientes con enfermedades glomerulares.

Pacientes y métodos

Este estudio se realizó en 50 pacientes con enfermedad glomerular confirmada mediante biopsia renal y 50 controles sanos emparejados por edad y sexo. A todos los participantes se les realizó una evaluación clínica, de laboratorio y un examen capilaroscópico del lecho ungueal.

Resultados

La nefritis lúpica fue el tipo patológico más común entre el grupo de glomerulonefritis (17 [34%]), seguida de la glomeruloesclerosis focal y segmentaria (9 [18%]). Los capilares tortuosos fueron significativamente mayores en pacientes con enfermedades glomerulares primarias en comparación con personas sanas (92,9%, 58%, p <0,001). El diámetro fue significativamente menor en pacientes con enfermedades glomerulares primarias en comparación con el grupo de control sano (15,6μm vs. 18,9μm, p=0,001). El plexo venoso subpapilar (28,6% vs. 6%; p=0,02) y la microhemorragia capilar (32% vs. 0, p <0,001) fueron significativamente más frecuentes en pacientes con enfermedades glomerulares primarias en comparación con el grupo de control. Los pacientes con nefritis lúpica tuvieron mayor diámetro capilar (19,5 vs. 15,6μm, p=0,02), ancho (55.6 vs. 44μm, p=0,003) y microhemorragia (64,7% vs. 32%, p=0,03) en comparación con los pacientes con glomerulonefritis primaria.

Conclusión

Se encontraron capilares más tortuosos y menor diámetro capilar en pacientes con enfermedad glomerular primaria en comparación con personas sanas. Los pacientes con nefritis lúpica tenían capilares más dilatados y más microhemorragia capilar en comparación con los pacientes con glomerulonefritis primaria.

Palabras clave:
Glomerulonefritis
Capilaroscopia del pliegue ungueal
Nefritis lúpica
Enfermedades glomerulares

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