The Relationship Between Gluten Enteropathy and Nail Capileroscopy Findings and Disease Activation

Abstract

Objective: Nailfold Videocapilloroscopy (NVC) is an examination method that is used as an aid in the diagnosis, follow-up, and treatment strategy of rheumatic diseases such as systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, and gives an idea about microcirculation by examining the vascular bed. It is a cheap, easily applicable, and quickly accessible method. Because of these features, we aimed to use the NVC method in patients with Gluten Enteropathy (GE) to determine whether this method will be a helpful technique in the diagnosis, activation decision, remission follow-up, and treatment strategy in patients with GE. Methods: In this study, 67 patients diagnosed with GE (n=35 disease-active group (AGE), n=32 disease-related remission group (RGE), and control group (CG)-27 healthy people whose diagnosis of GE was ruled out were included in this study. Group and CG were divided into ten parameters in capillary pathologies (capillary density loss, dilated capillary, giant capillary, microhemorrhage, avascular area, tortuosity, branched capillary, disorganization, extravasation, angiogenesis). They were divided into two groups as RGE and compared with the results obtained from NVC measurements Results: When patients diagnosed with GE and CG were evaluated in terms of capillary disorder with NVC, While all of the patients with capillary disorders were in the GE group, no capillary disorders were found in the control group (p<0.01). When patients diagnosed with GE were divided into two groups (AGE and RGE), NVC measurements were compared; All patients with capillary disorders were found in the AGE group (p<0.01). Capillary density loss and/or avascular area were detected in 80.9% of patients with capillary disorders. Conclucion: Our study found a statistically significant difference in NVC measurements between GE patients and CG (p<0.01). The fact that all patients with capillary disorders were in the active group in terms of the disease and no capillary disorders were detected in any patients in remission showed that this method could be used as an auxiliary technique in the diagnosis of GE, making the decision of activation or remission, monitoring the disease and determining treatment strategies.