Capillaroscopic findings in patients with sjögren’s syndrome, systemic sclerosis, and primary raynaud’s phenomenon in a high complexity center in Medellín, Colombia 2016-2022

Background: In Sjögren’s syndrome (SS), it has been suggested that capillaroscopy could be useful to identify patients with characteristics of overlap syndromes and risk of evolving into another connective tissue disease, in addition to determine extraglandular systemic involvement. The published information is scarce, as its comparison with systemic sclerosis (SSc) and primary Raynaud’s phenomenon (pRP); in addition, different optical instruments other than the videocapillaroscope with 200x magnification have been used.
Objectives: To assess capillaroscopic findings in patients with SS compared to subjects with SSc and pRP at a national capillaroscopy reference center in Medellín, Colombia, between 2016 and 2022.
Methods: An analytical cross-sectional observational study was carried out. Patients over 18 years who met 2016 ACR/EULAR, 2013 ACR/EULAR, and 2014 international criteria for SS, SSc, and pRP, respectively, confirmed by a rheumatologist, were included. Capillaroscopic variables were analyzed (number of capillaries per millimeter, dilated capillaries, megacapillaries, abnormal capillaries, microhemorrhages, avascular zones, arborescent capillaries, capillary disorganization, and capillaroscopic pattern).
Qualitative variables were expressed by absolute and relative frequencies and the quantitative by the median and interquartile range (IQR) due to the heterogeneous distribution of data.
Results: In total, there were 195 patients, of which 181 (92.8%) were female; the median age was 53 years (IQR:39-62). The most frequent capillaroscopic finding in SS was the presence of dilated capillaries (n=36; 55.4%). A higher frequency of global capillaroscopic abnormalities was observed in the SSc group compared to the other groups (p<0.0001 in all comparisons). There was no difference in the frequency of arborescent capillaries between the SS and SSc groups. In the SS group, either scleroderma pattern was found in 18.5% (n=12)