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Graft-versus-host Disease

Nailfold capillary abnormalities in sclerodermatous chronic GVHD

Bone Marrow Transplantation volume 48, pages 1574–1577 (2013)Cite this article

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Abstract

Chronic GVHD (cGVHD) complicating allo-SCT commonly presents as sclerotic skin changes resembling systemic sclerosis (SSc), suggesting a common pathophysiological pathway. Damage to capillaries is considered an early event in the pathogenesis of SSc, and is associated with characteristic nailfold capillary abnormalities. Whether such nailfold capillary abnormalities occur in sclerodermatous cGVHD is unknown. Nailfold videocapillaroscopy (NVC) was used to evaluate capillary morphology, density and loop dimensions in 14 patients with sclerodermatous cGVHD, 14 sex- and age-matched SSc patients, and 14 healthy controls. It was shown that none of the cGVHD patients and controls, whereas all SSc patients showed severe capillary abnormalities. cGVHD patients and controls showed no differences in capillary density (9.05 vs 9.16 loops/mm, respectively, P=0.84), and capillary loop dimensions (total loop width 44.36 vs 45.56 μm, respectively, P=0.84). Compared with cGVHD patients, SSc patients had a reduced capillary density (9.05 vs 5.25 loops/mm, respectively, P<0.001), and an increase in capillary loop dimensions (total loop width 44.36 vs 99.97 μm, respectively, P=<0.001). In conclusion sclerodermatous cGVHD patients do not show the characteristic microvascular abnormalities seen in SSc, suggesting that capillary damage does not contribute to the pathophysiology of sclerodermatous cGVHD, and making NVC unsuitable for early identification.

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Acknowledgements

The software to create the panorama mosaic images was received as a license agreement from the University of Manchester (UK).

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Authors and Affiliations

  1. Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands

    H M A Hofstee, Y M Smulders & E H Serné

  2. Department of Haematology, Isala Clinics, Zwolle, The Netherlands

    T T de Waal

  3. Department of Haematology, VU University Medical Center, Amsterdam, The Netherlands

    S Zweegman, M C E Schoordijk & J J W M Janssen

  4. Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands

    A E Voskuyl

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  1. H M A Hofstee
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Hofstee, H., de Waal, T., Zweegman, S. et al. Nailfold capillary abnormalities in sclerodermatous chronic GVHD. Bone Marrow Transplant 48, 1574–1577 (2013). https://doi.org/10.1038/bmt.2013.106

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