title: Prevalence of Raynaud phenomenon and nailfold capillaroscopic abnormalities in Fabry disease: a cross-sectional study.
abstract: Fabry disease (FD) is a lysosomal disorder leading to progressive systemic involvement, including microvascular damage that leads to neurological and cardiovascular disorders. We hypothesize that the latter could be documented at an early stage by performing a microcirculation study with nailfold capillaroscopy and evaluation of Raynaud phenomenon.The objective was to measure the prevalence of Raynaud phenomenon and nailfold capillaroscopic abnormalities in FD.This cross-sectional study included a standardized questionnaire and a nailfold capillaroscopy that assessed previously reported patterns in FD (dystrophic and giant capillaries, avascular fields, irregular architecture, dilatation and density of capillaries, hemorrhage), and was conducted on 32 Fabry patients and 39 controls. Capillaroscopic photographs were reviewed by 2 independent blinded investigators.Twelve Fabry patients (38%) suffered from Raynaud phenomenon, 5 were males (ie, 50% of male Fabry patients), compared with 2 controls (13%) (P < 0.001), of whom none were males (P < 0.001). Raynaud phenomenon was concomitant or before the occurrence of pain in the extremities in 42% of Fabry patients.More ramified capillaries were significantly observed in Fabry patients (12/32, 38%) than in controls (5/39, 13%, P = 0.016).Secondary Raynaud phenomenon should lead to screening for FD, especially in men. By extension, in high-risk populations for FD, the presence of Raynaud phenomenon and ramified capillaries should be assessed.
authors.affiliation: From the Departments of Internal Medicine (SD, BB) and Biostatistics (JJP), C.H.U. Côte de Nacre, Caen; University of Tours, Inserm Imagerie et Cerveau UMR U930, Tours (LA); Department of Internal Medicine and Infectious Diseases, C.H.U. Robert Debré, Reims, France (RJ); Department of Internal Medicine, Hôpital de la Croix Saint-Simon, Paris (OL); APMF, Vendresse (NT); Department of Internal Medicine, C.H.U. Michallon, Grenoble, France (BI).
authors.forename: Samuel
authors.initials: S
authors.lastname: Deshayes
authors.forename: Laurent
authors.initials: L
authors.lastname: Auboire
authors.forename: Roland
authors.initials: R
authors.lastname: Jaussaud
authors.forename: Olivier
authors.initials: O
authors.lastname: Lidove
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Parienti
authors.forename: Nathalie
authors.initials: N
authors.lastname: Triclin
authors.forename: Bernard
authors.initials: B
authors.lastname: Imbert
authors.forename: Boris
authors.initials: B
authors.lastname: Bienvenu
authors.forename: Achille
authors.initials: A
authors.lastname: Aouba
mesh_terms: D002196:Capillaries / Q000473:pathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D000795:Fabry Disease / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D009262:Nails / Q000098:blood supply*; D015995:Prevalence; D011928:Raynaud Disease / Q000453:epidemiology / Q000209:etiology*; D012737:Sex Factors