Sclerodermia sistemică este o afecțiune autoimună multisistemică rară, caracterizată prin fibroză cutanată, a organelor interne și injurie vasculară. De regulă, diagnosticul se stabilește tardiv, după survenirea modificărilor ireversibile. Unul din simptomele timpurii ale bolii este fenomenul Raynaud. Capilaroscopia este o metodă neinvazivă și accesibilă, care facilitează depistarea semnelor de injurie endotelială la pacienții cu fenomen Raynaud, la etape precoce ale bolii. În acest articol, autorii prezintă cazul clinic al unei paciente de sex feminin, cu vârsta de 12 ani, internată în secția de Reumatologie a IMSP IM și C cu acuze la prezența fenomenului Raynaud, artralgii periodice, dureri epigastrale. Investigațiile de laboraror au fost în limitele normei, inclusiv cele imunologice (anticorpi pe celule Hep-2, anticorpi anti-antigeni nucleari extractibili). Însă, datele capilaroscopiei periunghiale au sugerat faza precoce a sclerodermiei sistemice. S-au efectuat investigații pentru aprecierea afectării organelor țintă, la care s-au depistat date de fibroză pulmonară incipientă și esofagită catarală. A fost stabilit diagnosticul de sclerodermie sistemică și inițiat tratament de fond. În acest caz, capilaroscopia periunghială a avut un rol crucial în stabilirea timpurie a diagnosticului și inițierea tratamentului până la survenirea complicațiilor ireversibile.

Systemic sclerosis is a rare and multisystemic autoimmune condition, characterized by skin and visceral fibrosis, and vascular damage. Usually, the diagnosis is made late when irreversible changes in skin and internal organs occur. Raynaud’s phenomenon is one of the earliest symptoms of the disease. Capillaroscopy is a simple and non-invasive technique, able to differentiate between isolated and secondary Raynaud’s. This article is described a case of a 12-yearold female patient, with Raynaud phenomenon, arthralgias and epigastric pain. Laboratory workup, including immunologic examinations (antinuclear antibodies and antibodies to extractable nuclear antigens) were inconclusive. Capillaroscopy revealed scleroderma pattern. Additional investigations, t.e. computed tomography and upper gastrointestinal endoscopy showed scleroderma characteristic changes – early pulmonary fibrosis and cattharal esophagitis. A diagnosis of systemic sclerosis was made and the patient started disease-modifying treatment. In this case, nailfold capillaroscopy had a crucial role for the early diagnosis and treatment before irreversible complication occurred.

Systemic sclerosis is a rare and multisystemic autoimmune condition, characterized by skin and visceral fibrosis, and vascular damage. Usually, the diagnosis is made late when irreversible changes in skin and internal organs occur. Raynaud’s phenomenon is one of the earliest symptoms of the disease. Capillaroscopy is a simple and non-invasive technique, able to differentiate between isolated and secondary Raynaud’s. This article is described a case of a 12-yearold female patient, with Raynaud phenomenon, arthralgias and epigastric pain. Laboratory workup, including immunologic examinations (antinuclear antibodies and antibodies to extractable nuclear antigens) were inconclusive. Capillaroscopy revealed scleroderma pattern. Additional investigations, t.e. computed tomography and upper gastrointestinal endoscopy showed scleroderma characteristic changes – early pulmonary fibrosis and cattharal esophagitis. A diagnosis of systemic sclerosis was made and the patient started disease-modifying treatment. In this case, nailfold capillaroscopy had a crucial role for the early diagnosis and treatment before irreversible complication occurred.

Системная склеродермия является редким многосистемным заболеванием, которое характеризуется наличием фиброза кожи, внутренних органов и поражением сосудов. Как правило, диагноз выставляется с опозданием, когда появляются классические симптомы заболевания. Одним из ранних симптомов является феномен Рейно. Капилляроскопия – это неинвазивный метод обследования, который помогает отличить изолированный феномен Рейно от вторичного феномена Рейно. В этой статье авторы описывают случай 12-летней пациентки, поступившей с жалобами на феномен Рейно, боли в суставах и эпигастрии. Лабораторные данные, в том числе иммунологически (антинуклеарные антитела и антитела против экстрагируемых ядерных антигенов) не выявили изменения. При капилляроскопии был выявлен паттерн склеродермия. Это послужило причиной для дополнительных обследований, где определилось наличие начального лёгочного фиброза и катарального эзофагита. На этом основании, был поставлен диагноз системной склеродермии и фоновое лечение было начато на начальных стадиях заболевания, до появления необратимых изменений.