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Vol. 19. Issue 5.
Pages 255-259 (May 2023)
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Vol. 19. Issue 5.
Pages 255-259 (May 2023)
Original article
The role of nailfold capillaroscopy in pediatric patients with Kawasaki disease
El papel de la capilaroscopia periungueal pacientes pediátricos con la enfermedad de Kawasaki
Banafsheh Sedaghata,e,1, Sayed-Reza Raeeskaramia,b,c,1, Fatemeh Tahghighia,b,c, Raheleh Assaria,b,c, Ehsan Aghaei-Moghadama,b, Niloofar Razavi-Khorasania,b,c,d, Seyed-Reza Najafizadehd, Vahid Ziaeea,b,c,d,
Corresponding author
ziaee@tums.ac.ir

Corresponding author.
a Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
b Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
c Pediatric Rheumatology Society of Iran, Iran
d Rheumatology Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
e Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Figures (2)
Tables (2)
Table 1. The frequency of various coronary artery involvement among KD patients.
Table 2. The comparison of nailfold capillaroscopy findings between patients with Kawasaki disease (KD) and controls.
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Abstract
Background

Nailfold capillaroscopy has been used as a non-invasive diagnostic method for microvasculature evaluation in various rheumatological disorders. The present study aimed to determine the utility of nailfold capillaroscopy in the diagnosis of Kawasaki Disease (KD).

Method

In this case–control study nailfold capillaroscopy was performed in 31 patients with KD and 30 healthy controls. All nailfold images were evaluated for capillary distribution and capillary morphology such as enlargement, tortuosity, and dilatation of the capillaries.

Result

Abnormal capillaroscopic diameter was identified in 21 patients from the KD group and 4 patients in the control group. The most common abnormality in capillary diameter was irregular dilatation in 11 (35.4%) KD patients and in 4 people (13.3%) in the control group. Distortions of the normal capillary architecture was commonly seen in the KD group (n=8). A positive correlation was observed between coronary involvement and abnormal capillaroscopic results (r=.65, P<.03). The sensitivity and specificity of capillaroscopy for the diagnosis of KD were 84.0% (95%CI: 63.9–95.5%) and 72.2% (95%CI: 54.8–85.8%), respectively. The PPV and NPV of capillaroscopy for KD were 67.7% (95%CI: 48.6–83.3) and 86.7% (95% CI: 69.3–96.2), respectively.

Conclusion

Capillary alterations are more common in KD patients compared to control group. Thus, nailfold capillaroscopy can be useful in detecting these alterations. Capillaroscopy is a sensitive test for detecting capillary alternations in KD patients. It could be used as a feasible diagnostic modality for evaluating microvascular damage in KD.

Keywords:
Kawasaki disease
Microcirculation
Nailfold capillaroscopy
Rheumatic diseases
Resumen
Antecedentes

La capilaroscopia periungueal se ha utilizado como un método diagnóstico no-invasivo para evaluación de la microvasculatura en varios trastornos reumatológicos. El presente estudio pretendió determinar la utilidad de la capilaroscopia periungueal en el diagnóstico de la enfermedad de Kawasaki (KD).

Método

En este estudio de casos y controles se realizó la capilaroscopia periungueal para 31 pacientes con KD y 30 controles sanos. Todas las imágenes de la ungueal se evaluaron para la distribución capilar y la morfología capilar, como la ampliación, la tortuosidad y la dilatación de los capilares.

Resultado

Se identificó un diámetro capilaroscópico anormal en 21 pacientes del grupo KD y en 4 pacientes del grupo control. La anomalía más común en el diámetro de los capilares fue la dilatación irregular en 11 (35,4%) pacientes con KD y 4 personas (13,3%) en el grupo control. Las distorsiones de la arquitectura capilar normal se observaron comúnmente en el grupo KD (n=8). Se observó una correlación positiva entre la afectación coronaria y los resultados capilares anormales (r=0,65, p <0,03). La sensibilidad y la especificidad de una capilaroscopia para el diagnóstico de KD fueron del 84,0% (IC del 95%: 63,9-95,5%) y del 72,2% (IC del 95%: 54,8-85,8%), respectivamente. El VPP y el VAN de la capilaroscopia para KD fueron del 67,7% (IC del 95%: 48,6-83,3) y del 86,7% (IC del 95%: 69,3-96,2), respectivamente.

Conclusión

Las alteraciones capilares son más frecuentes en los pacientes con KD en comparación con el grupo control. Así, la capilaroscopia periungueal puede ser útil en la detección de estas alteraciones. La capilaroscopia es una prueba sensible para detectar las alteraciones capilares en pacientes con KD. Podría utilizarse como modalidad diagnóstica factible para evaluación el daño microvascular en la KD.

Palabras clave:
Enfermedad de Kawasaki
Microcirculación
Capilaroscopia periungueal
Enfermedades reumáticas

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