Microangiopathy in Rheumatic Diseases

Dear Colleagues,

Raynaud’s phenomenon (RP) is a frequent symptom in rheumatic diseases. The frequency of RP is highest in systemic sclerosis (SSc), in which it occurs in more than 90% of cases as it frequently precedes other symptoms of the diseases. Endothelial dysfunction is a key initial process in the pathogenesis of SSc. In patients with undifferentiated connective tissue disease, it is observed in approximately half of the patients, in systemic lupus erythematosus—in 1/3 of cases. An easy and accessible method for evaluation of the microvascular pathology is capillaroscopy. The characteristic pathological capillaroscopic changes (“scleroderma” type capillaroscopic pattern) are observed in more than 90% of SSc patients and are included in the current classification criteria for the disease. Specific autoantibodies are also used to support the early diagnosis of the disease. Analogous capillaroscopic changes are observed also in other rheumatic diseases such as undifferentiated connective tissue disease, overlap syndromes, systemic lupus erythematosus, etc. (i.e., “scleroderma-like” capillaroscopic changes). As capillaroscopic features of microangiopathy are of crucial importance for early diagnosis of rheumatic diseases with peripheral vascular syndrome, important topic of research is studying the characteristics of early microangiopathy. In addition, differentiation between “scleroderma” and “scleroderma-like” capillaroscopic pattern is an interesting issue in the research agenda. Presence of association between capillaroscopic features of microangiopathy and autoantibodies is a question that is insufficiently studied in the contemporary rheumatology. The current Special Issue discusses different aspects of microangiopathy in rheumatic diseases whose better understanding would facilitate early diagnosis of microangiopathy and support improvement of knowledge of disease pathogenesis.

Dr. Sevdalina Lambova
Dr. Erik Lubberts
Topic Editors