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Background:Rheumatic musculoskeletal disorders (RMSDs) are a common cause of long term pain and physical disability. In developed countries, RMSDS are a major cause of absence from work and thus have a big financial burden on the country economic status. Several studies have been published the incidence and prevalence of RMSDs in different world countries and found to be widely variable. Estimation of the extend of the problem of RMSDs in developing world, especially in rural economies will help better understanding of the risk factors that contribute to the initiation and progression of these diseases and help the health care authorities to provide proper health program services in these areas to reduce the physical and financial burden of RMSDs (Bagher et al., 2011; Majumdar et al., 2015 and Usenbo, et al., 2015).Objectives:To estimate the prevalence rate of RMSDs in a rural population in Upper Egypt.Methods:A cross-sectional based study was carried out and included 3988 subjects of population (2013 females and 1975 males). Mean age of patients was (46.89±15.25ys). They proceeded 4 phases of World Health Organization/International League of Associations for Rheumatology community-oriented program for control of rheumatic diseases survey questionnaire WHO-ILAR Community Oriented Program for screening of rheumatic diseases. Modified Health Assessment Questionnaire (HAQ) was used to assess the disability severity. Individuals suspected to have any rheumatic diseases were subjected to full clinical examination, laboratory and radiological investigations to reach a final diagnosis. They were classified according to appropriate criteria of diagnosis of diseases.Results:A prevalence rate of RMSDs was 16.22%, more prevalence in females (10.38% vs. 5.84% for males, P=0.000). The mean age of patients with RRMSDSs were older (46.89±15.25 yrs) than healthy individuals (29.56±18.95 yrs) (P=0.0001) and with increasing age (≥45-≤ 55 yrs).The identified RMSDs were OA (8.5%), Soft tissue rheumatism (STR) (6.57%), spinal disorders (SD) (6.47%), fibromyalgia (FM) (0.60%), RA (0.30%), arthralgia (0.18%), SPAs (0.15%), Gout(0.6%), Pseudogout (0.08%), SLE (0.5%), JIA(0.03) and MCTD (0.03%). The prevalence rates for the majority of RRMSDSs were higher in females and with increasing age. About two thirds of the patients had grade II disability.Conclusion:The prevalence rate of RMSDs in a rural population ≥15years in Upper Egypt has been estimated to be 16.22%.The most prevalent RMSDs are OA, STR and SD causing the greatest burden of the disease. The predictive risk of RMSDs has to be assessed in future studies.References:[1]Majumdar A, Kumar SG, Nair D, Sujiv A. Musculoskeletal complaints and predictors of musculoskeletal pain among adults in rural puducherry. Indian J Palliat Care. 2015; 21(1):121-123.[2]Usenbo A, Kramer V, Young T, Musekiwa A. Prevalence of Arthritis in Africa: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10 (8):e0133858.[3]Bagher OM, Golbarg M, Hossein S. Pattern of rheumatic diseases in two outpatient clinics in Iran: similarities with some different features. Indian J Med Sci. 2011; 65(1):7-17.Disclosure of Interests:None declared

Background:Behcet’s disease (BD) is a chronic multi-systemic autoinflammatory disease associated with increase prevalence of psychiatric comorbidity(Ilhan et al. 2016). Pro-inflammatory cytokines have been reported to be elevated in patients with depression and anxiety. IL-23/IL-17 axis has been shown to play a remarkable role in pathogenesis of BD, depression and anxiety(Sugita et al. 2012, Gheita et al. 2015). However, the relation between the serum level of interleukin (IL)-17 and IL-23 and incidence of cognitive impairment, depression and anxiety in Behcet patients are still unknown.Objectives:To evaluate the serum levels of IL-17 and IL-23 in Egyptian patients with BD and evaluate the correlations between the level of inflammatory cytokines and psychiatric manifestations as cognitive impairment, depression and anxiety.Methods:Study design and recruitmentIn a case control study, we recruited 45 BD patients, who fulfilled the modified International Criteria for Behçet’s Disease(ITR-ICBD 2014) from the Rheumatology and Rehabilitation Department, Assiut University hospital. Thirty apparently healthy sex and age matched subjects were recruited, served as controls. This study was approved by the Ethical Committee of the Assiut University, Egypt. Informed consent was obtained from all participants.Study methodologyAll patients and controls were assessed for cognitive impairment, depression and anxiety using memory assessment scale, Hamilton depression rating scale and Hamilton anxiety rating scale respectively.Serum level of proinflammatory cytokines such as IL-17 and IL-23 were measured by enzyme-linked immunosorbent assay (ELIZA).Results:Psychiatric manifestationsBD has significant lower score in all components of MAS and high prevalence of depression and anxiety in HDRS and HARS respectively compared with control group (p Serum Levels of IL-17 and IL-23The serum level of IL-17 and IL-23 levels were significantly higher among BD patients than in healthy control (There was no significant correlation between those cytokines and cognitive impairment, depression and anxiety.Conclusion:Elevated level of IL-17 and IL-23 were observed in BD patients. However, our results do not support an association between serum IL-17 and IL-23 levels and cognitive dysfunction, depression and anxiety.References:[1]Gheita, T. A., S. M. Gamal, I. Shaker, H. S. El Fishawy, R. El Sisi, O. G. Shaker and S. A. Kenawy (2015). “Clinical significance of serum interleukin-23 and A/G gene (rs17375018) polymorphism in Behcets disease: Relation to neuro-Behcet, uveitis and disease activity.” Joint Bone Spine 82(3): 213-215.[2]Ilhan, B., M. Can, F. Alibaz-Oner, S. Yilmaz-Oner, O. Polat-Korkmaz, G. Ozen, G. Mumcu, H. Maradit Kremers and H. Direskeneli (2016). “Fatigue in patients with Behcet’s syndrome: relationship with quality of life, depression, anxiety, disability and disease activity.” Int J Rheum Dis.[3]ITR-ICBD (2014). “The International Criteria for Behcet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria.” J Eur Acad Dermatol Venereol 28(3): 338-347.[4]Sugita, S., Y. Kawazoe, A. Imai, Y. Yamada, S. Horie and M. Mochizuki (2012). “Inhibition of Th17 differentiation by anti-TNF-alpha therapy in uveitis patients with Behcet’s disease.” Arthritis Res Ther 14(3): R99.Disclosure of Interests: :None declared

Background SLE is clinically and immunologically heterogeneous. Type I interferons (IFN-I) are pathogenic but expression of IFN-I stimulated genes varies. Many existing reports on clinical phenotype and IFN-I were limited by using categorical measures of IFN-I and disease activity scores that were not organ-specific. IFN-I targeted therapies are in development. Objectives To define the clinical phenotype of IFN-I mediated SLE. Methods 108 SLE patients and 20 age and sex matched healthy controls were studied. Activity was measured using BILAG-2004. PBMCs were collected for gene expression analysis using TaqMan. Relative expression of 7 interferon stimulated genes was In-transformed, normalized to healthy control and summed to derive a 7-gene IFN-I score. Results The most common activity was mucocutaneous and musculoskeletal, which were analysed in detail (Table 1). The relationship between activity and IFN-I score differed between these domains. Overall, IFN-I scores were higher in active mucocutaneous disease. Scores were more variable for BILAG B: this was explained by subtype of BILAG B disease. IFN-I score was increased in subacute and discoid forms (25.3 (16.8–32.9), n=7) compared to acute forms (18.4 (4.9–31), n=15). Score was also higher in patients with anti-Ro60. In contrast, there was no relationship between musculoskeletal disease activity and IFN-I score. Numbers of patients with renal, haematological and neuropsychiatric activity were limited but there was a trend to higher IFN-I scores with disease activity. Conclusions We identify a relationship between clinical presentation of SLE and IFN-I. High IFN-I activity is linked to anti-Ro60 and non-acute forms of skin disease. We previously reported a worse response to rituximab in this subgroup, whilst response in musculoskeletal disease was consistently good. Measurement of B cell and interferon biomarkers may therefore be important in the selection of the most appropriate targeted therapy for SLE. Disclosure of Interest None declared