Primary Pulmonary Hypertension Is Not Associated With Scleroderma-Like Changes in Nailfold Capillaries

Abstract

Study objectivesTo determine whether primary pulmonary hypertension (PPH) is associated with scleroderma-like changes in nailfold capillaries. DesignBlinded, prospective, case-control study. SettingUniversity medical centers in Baltimore, MD. PatientsThirty-seven patients with PPH, 15 patients with scleroderma, and 13 healthy control subjects. MeasurementsSubjects underwent nailfold capillary videomicroscopy of the fourth digits of both hands. Capillary images were evaluated by two blinded, trained graders according to standardized criteria for the presence of scleroderma nailfold changes. ResultsThe prevalence of scleroderma-associated nailfold changes in patients with PPH (1 of 37 patients) was dramatically lower than that in patients with scleroderma (9 of 15 patients; p < 0.0001). The distribution of nailfold grades for the PPH patients was indistinguishable from that of the healthy control subjects. ConclusionPPH is not associated with scleroderma-like vasculopathy of nailfold capillaries.