Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492007000400005
Jornal Vascular Brasileiro
Original Article

Nailfold video capillaroscopy in Turner syndrome: a descriptive study

Videocapilaroscopia na síndrome de Turner: estudo descritivo

Simone C. S. Coelho; Andressa D. Ramos; Virgínia S. Pinheiro; Paulo F. C. Solberg; Janaina P. de Faria; Erika C. O. Naliato; Therezinha J. Fernandes; Marília M. Guimarães

http://dx.doi.org/10.1590/S1677-54492007000400005 J Vasc Bras, vol.6, n4, p.325-331, 2007
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Abstract

BACKGROUND: An increased prevalence of impaired glucose homeostasis is reported in Turner syndrome. Endothelial changes are described in patients with insulin resistance, which may be present in patients with Turner syndrome. Video capillaroscopy is a noninvasive examination that allows assessment of vascular patency. OBJECTIVE: To describe the nailfold morphology of capillaries in Turner syndrome using video capillaroscopy. METHODS: Subjects were studied in a temperature-controlled room, 20 days after no nailfold manipulations. The capillaries were visualized by microscope connected to a television and computer and were studied and classified according to these patterns: loop distribution, papilla, avascular fields, edema, form, capillary limbs, flow and hemorrhagic extravasation. RESULTS: Fifty patients aged between 6-37 years with Turner syndrome were studied. Eighteen (36%) patients had normal capillaroscopy with hairpin pattern in loop distribution and no avascular fields. The papilla was ratified in 13 (26%) and enlarged in four (8%). Edema occurred in 22 (44%) cases. There were three (6%) macrocapillaries and three (6%) were branched. Tortuosity was present in five (10%) patients. Hemorrhagic extravasation occurred in one (2%) case. Flow was fast in seven (14%), granulous in five (10%) and slow in six (12%). CONCLUSION: There was a high prevalence of nailfold capillaroscopy changes in Turner syndrome and the most prevalent alterations found were edema and ratified papilla.

Keywords

Turner syndrome, nailfold capillaroscopy, endothelium

Resumo

CONTEXTO: Estudos evidenciam distúrbios no metabolismo da glicose na síndrome de Turner. As alterações no endotélio estão descritas em pacientes com resistência insulínica, que pode ocorrer em pacientes com síndrome de Turner, e o estudo dos capilares pela videocapilaroscopia é um exame não-invasivo que permite avaliação da permeabilidade vascular. OBJETIVO: Descrever a morfologia dos capilares na síndrome de Turner usando a videocapilaroscopia. MÉTODO: As pacientes foram estudadas em sala com temperatura controlada, após 20 dias sem manipulação das cutículas. Os capilares foram visualizados por microscópio conectado à televisão e computador, sendo estudados de acordo com os seguintes parâmetros: distribuição de alças, papila, praias desertas, edema, forma, tamanho, fluxo e hemorragia. RESULTADOS: Cinqüenta pacientes com síndrome de Turner foram estudadas, com idades entre 6 e 37 anos. Dezoito (36%) tiveram exame normal com distribuição de alças com padrão em paliçada e sem praias desertas. A papila foi retificada em 13 (26%) e alargada em quatro (8%). Edema ocorreu em 22 (44%) casos. Havia três (6%) capilares ectasiados e três (6%) eram ramificados. Tortuosidade estava presente em cinco (10%) pacientes. Hemorragia ocorreu em um (2%) caso. O fluxo foi rápido em sete (14%), granuloso em cinco (10%) e lento em seis (12%). CONCLUSÃO: Houve uma maior prevalência de anormalidades na videocapilaroscopia na síndrome de Turner, e as alterações mais comuns foram edema e papila retificada.

Palavras-chave

Síndrome de Turner, videocapilaroscopia, endotélio

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