Kapillarmikroskopie

Zeitschrift für Rheumatologie - Tập 72 - Trang 145-150 - 2013
J. Richter1, C. Iking-Konert2, M. Schneider1, O. Sander1
1Poliklinik für Rheumatologie, Heinrich Heine-Universität Düsseldorf, Düsseldorf, Deutschland
2Medizinische Klinik III, Abteilung für Nephrologie und Rheumatologie, Universitätsklinik Hamburg Eppendorf, Hamburg, Deutschland

Tóm tắt

Zwei Jahre nach der Veröffentlichung der deutschsprachigen Konsensarbeit zu Nomenklatur und Durchführung der Kapillarmikroskopie in dieser Zeitschrift gibt es relevante Neuerungen. Zertifizierte Schulungen in der Kapillarmikroskopie unter dem Dach der Rheumaakademie haben flächendeckend über 300 Rheumatologen erreicht. Geschulte Untersucher zeigen deutlich größere Übereinstimmung in der Befundung als nicht geschulte Experten mit jahrelanger Erfahrung. Normalbefunde konnten anhand der Nomenklatur in einer großen Kohorte erfasst werden. Die Zahl der Publikationen zur Kapillarmikroskopie ist deutlich gestiegen, prospektive Untersuchungen von kleineren Kohorten und der Vergleich zu anderen Methoden insbesondere bei der systemischen Sklerose, dem Raynaud-Syndrom (RS), aber auch bei anderen Erkrankungen spielen die Hauptrolle. Aber auch eine große prospektive multizentrische europäischen Studie unter Verwendung des Capillaroscopic Skin Ulcer Risk Index (CSURI) wurde unter deutscher Beteiligung durchgeführt. Die Rolle als Screening-Instrument wird von der Mehrzahl der Untersuchungen bestätigt. Der kapillarmikroskopische Befund hat im diagnostischen Algorithmus der Differenzialdiagnostik des RS einen festen, unverzichtbaren Stellenwert erlangt und gehört zum Diagnosealgorithmus für die frühzeitige Diagnose der systemischen Sklerose. Auch beim systemischen Lupus erythematodes wird sie zunehmend in der Diagnostik als ergänzende Untersuchung durchgeführt. In Kliniken und Praxen werden neben dem traditionellen Auflichtmikroskop zunehmend Videokapillaroskope und einfache USB-Mikroskope eingesetzt.

Tài liệu tham khảo

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