Nailfold Capillaroscopy in Hypothyroidism and Hyperthyroidism: Blood Flow Velocity During Rest and Postocclusive Reactive Hyperemia

Abstract

Direct intravital microscopic examinations of nailfold capillaries were made in three groups of subjects: 15 healthy volunteers (C) and 11 patients, six with hypothyroidism (h) and five with hyperthyroidism (H). The groups h and H were examined twice, before the onset of treatment and when they returned to euthyroidism. Capillary blood flow velocity (CBFV) was measured during rest and after release of 60-second arterial occlusion. To assess autoregulatory capacity the authors determined peak CBFV postoc clusion and time to reach it in single capillaries. In patients with hypothyroidism, before the onset of the treatment, the mean resting and the mean peak CBFV were significantly lower (resting CBFV—group C: 0.93 ±0.11 mm/s (mean ±SE); group h: 0.33 ±0.09 mm/s; and mean peak CBFV—group C: 1.49 ±0.14 mm/s; group h: 0.79 ±0.19 mm/s). The time to reach mean peak CBFV postocclusion was significantly prolonged (group C: 8.9 ±0.65 s and group h: 19.2 ±2.0 s) compared with the group of healthy volunteers. When these patients achieved euthyroidism, all the studied parameters returned to control levels. In patients with hyperthyroidism only minor changes in CBFV could be detected. In patients with hypothyroidism, the skin microvascular autoregulatory mech anisms are disturbed. The impairments of the reactive hyperemia response could be corre lated with the control of the disease (thyroid state).