Wednesday, February 8, 2012

Capillary Microscopy - some comments on an actual patient of today

The picture of the capillary microscopy I’m going to put up here shows megacapillaries, elongations, slight torquations, and moreover capillary bleedings. Quite a lot of autoimmune diseases can show these alteration. I have some colleagues from the dermatology department a couple of kilometres west of our hospital, who think it’s scleroderma. But I don’t think so. Our patient is 66 years old and I could be friends with a diagnosis like “oligosymptomatic CREST syndrome”, but I still prefer undifferentiated connective tissue disease. ESR, CRP. C3, C4, etc. normal. Antinuclear autoantibodies 1:5120 nuclear, and the only findings in the immunoblot are Ro-52 and M2-PDH. AMA, however are negative. Hopefully for the lady, we have to wait for a couple of years more to make sure, which diagnosis is appropriate.

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