The presence of Raynaud9s phenomenon involves the screening of connective pathologies. Because today capillaroscopy has become important as diagnostic criteria for scleroderma, within the protocol evaluation of patients with Raynaud it would be appropriate to hold at least one capillaroscopy, hence the interest of this study.

Objectives

Descriptive study of capillaroscopic findings in patients with primary Raynaud9s phenomenon suspected without other clinical data of connective pathologies.

Methods

Capillaroscopic reports were reviewed of patients with positive Raynaud9s phenomenon, positive or not antinuclear antibodies but negative ENA, who had no other data of connective pathologies, conducted between January 2012 and December 2014. Capillaroscopy was performed according to standard protocol, by a single physician experienced in capillaroscopy. Described three patterns: Normal pattern there may be some simple tortuosity. Suspicious pattern predominates capillary tortuosity in the form of spins and tangles. Scleroderma pattern: presence of giant capillaries, capillary bleeding and consequent destruction with avascular zones. Statistical analysis was performed using SPSS 15.0 software.

Results

We found 69 patients who met the proposed criteria, of which 64 (93%) were women and only five (7%) male, the mean age was 39 years (±15.19). The history of snuff was present in 25 (36%) patients. Eight (12%) patients exposed to cold working. The ANA were positive in 18 (26%) patients, of these, 16 cases (89%) with ANA titers below 1/320; history of hypothyroidism was collected in 11 (16%) patients. The results of capillaroscopy no patient was seen sclerodermiform pattern being normal 65 (95.7%) patients, the dubious pattern was described only in 3 (4.3%) patients, with duration of more than 10 years in 2 cases and more 5 years in one case, three had positive ANA with a speckled pattern. Not was seen giant capillary or absence of capillaries in any patient, the tortuosity are described in 32 (46%) patients and in 4 (6%) patients was seen shoal-fish image.

Conclusions

Our results agree with those reported in the literature on primary Raynaud9s phenomenon is more common in women and in the absence of data connective pathologies (with the exception of positive ANA), hopefully a capillaroscopic normal result, further we help corroborate the primary origin of this disease. It is noteworthy that in patients with positive ANA most had titles below 1/320. the most common pattern capillaroscopic were simple tortuosity which could justify the structural pathophysiology of manifestation of the phenomenon of Primary Raynaud, these findings are consistent and that we know can be slight alterations as tortuous and irregular capillaries. We can conclude that the capillaroscopy is a useful tool in screening protocol of connective pathologies. We have yet to study the evolution of our patients over time, a normal capillaroscopy does not imply absence of autoimmune disease process and only prospective cohort studies will allow assess its real value.

Disclosure of Interest

None declared

Scleroderma (fungus)

10.1136/annrheumdis-2015-eular.5602

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Changes in body composition in patients with ischaemic heart disease and post-COVID-19 syndrome.

Laura Arcos Arturo Orea Dulce González Rocío González Sánchez Emilio Gutiérrez

Ischaemic heart disease

10.1183/13993003.congress-2024.pa307

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[Anaphylaxis and hepatomegaly in a 22-year-old patient].

PubMed (1992)

Raúl Martínez‐Fernández Ana Beltrán Arranz Luís Manzano Melchor Álvarez‐Mon F. Albarrán

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AB0035 TWO DIFFERENT ABNORMAL BEHAVIORS IN CD4+T LYMPHOCYTES IN FIBROMYALGIA PATIENTS AND FIBROMYALGIA ASSOCIATED TO SJÖGREN’S SYNDROME

Annals of the Rheumatic Diseases (2020)

J. Monserrat-Sanz A. Movasat María Dolores Sosa-Reina Ana M. Gómez-Lahoz C. Bohórquez Heras

Background: Primary fibromyalgia syndrome is a prevalent rheumatic condition characterized by widespread pain and whose etiopathogenesis is not well understood. Fibromyalgia can also be secondary to other rheumatic diseases like Sjogren’s syndrome; however, its relation to this disease is unknown. It has been suggested that the immune system is involved in their pathogenesis. The role of activation stages and cytokines profiles of CD4+T lymphocytes in fibromyalgia or fibromyalgia secondary to Sjogren´s syndrome are completely unclear and could play a key role in the pathophysiology of these diseases. Objectives: The objective of this study is to investigate the counts and distribution of the CD4+T lymphocyte activation subsets and their pattern of cytokine production in women with primary fibromyalgia, fibromyalgia secondary to Sjogren´s, Sjogren´s syndrome and healthy controls (HC). The counts and distribution of naïve (T N ), central memory (T CM ), effector memory (T EM ) and effector (T E ) CD4+T lymphocyte subsets were analyzed in these diseases. Furthermore, we investigated their pattern of IL-4, IL-10, IL-17A, IFNγ, and TNFα production. Methods: Counts and distribution of CD4+T subsets (T N , T CM , T EM , T E) and their cytokine producing capacity were measured using multiparametric flow cytometry in peripheral blood mononuclear cells (PBMC) from 20 primary fibromyalgia, 15 fibromyalgia associated to Sjögren and 15 primary Sjögren patients and 15 female controls. Fibromyalgia and/or Sjögren’s syndrome were diagnosed based on ACR criteria. CD4+T cell activation stages were analyzed by the expression of the CD3, CD4, CD45RA, CD27 and CCR7 antigens. Cytokine CD4+T producing cells subsets were assayed stimulating PBMC during 6 hours, fixed, permeabilized and simultaneously stained with IL-4, IL-10, IL-17A, IFNγ, and TNFα intracellular cytokines. Results: Fibromyalgia patients showed a significant increase in the CD4+T, T N and T CM cells counts with compared to fibromyalgia secondary to Sjogren, Sjogren´s syndrome and HC. The counts of IL-17A, IL-4 and IFNγ producing CD4+T cells were increased in fibromyalgia patients with respect to HC. However, only IL17A and IFNγ, but not IL-4 producing CD4+T lymphocytes were increased with respect fibromyalgia secondary to Sjogren. These alterations were due to an increment of T EM IL-17A, T CM and T EM IL-4 and T N T CM and T EM IFNγ producing CD4+T cell subsets in fibromyalgia patients. Furthermore, IFNγ producing CD4+T cells were decreased in fibromyalgia secondary to Sjogren´s with respect to fibromyalgia patients and HC. Counts of T N TNFα producing CD4+ T cells were increased in fibromyalgia with respect fibromyalgia secondary to Sjogren. IL-10 producing CD4+T cells were normal in fibromyalgia but decreased in fibromyalgia secondary to Sjogren. Conclusion: Fibromyalgia patients show an abnormal circulating activation stages of CD4+T cells, as well as, express unusual elevated counts of CD4+T cells producing IL-17A, IL-4 and IFNγ. These alterations could differentiate two different pathologic and inflammatory behaviors of the T cell compartment between fibromyalgia and fibromyalgia secondary to Sjogren patients. References: [1]T helper 1 response is correlated with widespread pain, fatigue, sleeping disorders and the quality of life in patients with fibromyalgia.. Guggino G et al, Clin Exp Rheumatol. 2019. [2]A Comparative Study of Fibromyalgia, Rheumatoid Arthritis, Spondyloarthritis, and Sjögren’s Syndrome. Bucourt E et al, Pain Med. 2019 Disclosure of Interests: None declared

Pathogenesis

10.1136/annrheumdis-2020-eular.5524

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AB0028 The Abnormal CD4+T Lymphocyte Subset Distribution Shown by Naïve Rheumatoid Arthritis Patients Can be Modulated by Methotrexate Treatment

Annals of the Rheumatic Diseases (2015)

C. Bohórquez Heras Lynnette A. Ruiz C. Garcia A. Gόmez-La Hoz Ana Isabel Turrión

Background

Mechanisms regulating the chronic autoimmune response in rheumatoid arthritis (RA) are not well understood. However, activated T CD4+ play a pivotal role initiating and perpetuating the chronic inflammation characteristic for the disease.

Objectives

Evaluate the number and distribution of circulating CD4+ T lymphocytes and their CD4+ naïve T cells (T_N), central memory (T_CM), non-terminated effector memory (T_NTEM) and terminated effector memory (T_TEM) T cells subsets in a population of recently diagnosed DMARD naive RA patients before and along the first 6 months of methotrexate (MTX) treatment.

Methods

The number of circulating CD4+ T lymphocytes, and of their T_N, TM, TCM and TEM subsets in fifty untreated patients with RA before MTX treatment and at 3 and 6 months of treatment were assayed using a multiparametric flow cytometry. We also studied twenty-four age- and sex-matched healthy subjects as controls.

Results

RA naïve patients show a significant (p<0.05) expansion of the circulating CD4+ T_NTEM subset. MTX non responder naïve RA patients show from basal conditions a significative expansion of CD4+ T_NTEM lymphocytes and develop significant expansion of CD4+ T_CM, and CD4+ T_EM lymphocyte subsets along MTX treatment.

Conclusions

Recently diagnosed DMARD naive RA patients show involvement of the circulating CD4+ T lymphocytes activation/differentiation stage subsets. MTX treatment show immunomodulatory effects on CD4+ T lymphocyte compartment with different behavior in responder and non-responder patients.

Disclosure of Interest

None declared

10.1136/annrheumdis-2015-eular.2704

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