The association between nail fold capillaroscopic findings and lupus nephritis in patients with systemic lupus erythematosus

Elshater, Nehal Abd El Hamid; Abu Alfadl, Esam Mohamed; Alkady, Eman Abbas; Elsayed, Sahar A.

doi:10.21608/smj.2025.409396.1598

The association between nail fold capillaroscopic findings and lupus nephritis in patients with systemic lupus erythematosus

Document Type : Original Article

Authors

¹ 1Department of Rheumatology and Rehabilitation, Faculty of Medicine, Sohag University, Sohag, 82524, Egypt

² Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt

10.21608/smj.2025.409396.1598

Abstract

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with common vascular involvement. Nailfold capillaroscopic changes have been described in SLE.

Objectives. To detect the peripheral microvascular abnormalities in SLE patients by NFC and explore the relation between these abnormalities and lupus nephritis.

Methods. Fifty SLE patients with lupus nephritis (LN) fulfilling the 2019 EULAR/ACR classification criteria were included in our study. A thorough history taking, clinical, and rheumatological evaluation was conducted on each patient. The patient underwent SLEDAI calculation, and kidney biopsy were done as needed. Nailfold videocapillaroscopy was used to evaluate the capillary circulation.

Results. According to the capillaroscopic changes in SLE patients with and without LN, significant differences were observed regarding elongated and dilated capillaries. The comparison of the activity index and capillaroscopic changes in SLE patients revealed higher activity indices in patients with elongated capillaries. Elongated capillaries were associated with a greater chronicity index. Using Multivariate logistic regression analysis, it demonstrates that (Capillary length and venous limb) were predictors for LN in SLE.

Conclusion: Nailfold capillaroscopic changes, such as dilated or elongated capillaries, are more prevalent in SLE patients with LN compared to those without LN. Elongated capillaries are associated with elevated activity and chronicity indices in patients. Furthermore, venous limb and capillary length might serve as indicators of LN in individuals with SLE.

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