Antiphospholipid antibodies and anticoagulant therapy: capil
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by specific vascular and obstetric manifestations and by antiphospholipid antibodies (aPL) positivity.

This study aims to compare nailfold videocapillaroscopy (NVC) microvascular parameters in APS patients and non-symptomatic "aPL carriers" and to investigate their possible correlations with different aPL subtypes.

NVC was performed during standard evaluations in 18 APS patients, 24 "aPL carriers" without symptoms, and 18 control patients (CTR) taking oral anticoagulants for non-immunological indications. All patients were investigated for the presence of dilated capillaries, giant capillaries, microhemorrhages, capillary loss, and further non-specific/specific abnormalities by NVC. Every alteration was also classified according to a semi-quantitative score. Lupus anticoagulant, anticardiolipin antibodies, and antibeta2 glycoprotein I antibodies were tested in each patient.

--APS patients showed at NVC increased frequency of microhemorrhages—particularly a “comb-like” pattern (parallel hemorrhages)—than "aPL carriers".

--Of note, there were no significant differences concerning the isolated number of microhemorrhages between APS and the CTR group, but “comb-like” hemorrhages were significantly more frequent in the APS group.

--Not any significant correlation was found between the aPL subtypes and NVC parameters.

Conclusively, APS patients showed significantly a greater number of non-specific NVC abnormalities than "aPL carriers", particularly the “comb-like” NVC pattern. Oral anticoagulants may represent a confounding factor for isolated microhemorrhages. Not any correlation was found between aPL subtypes and NVC parameters.