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Background Chikungunya fever is characterised by a high probability of persistent rheumatological manifestations, producing a negative impact in the work, social and economic fields. Objectives To determine the frequency and type of rheumatologic involvement in the subacute and chronic phase of Chikungunya fever. Methods Descriptive, cross-sectional study. We included patients>16 years old with Chikungunya infection (real time PCR, IgM or IgG for Chikungunya) who consulted consecutively for rheumatic symptoms/signs from March 2015 to March 2016. According to the time of evolution, the disease was divided in 2 Phases: acute (≤10 days of duration) and subacute/chronic (≥11 days). According to clinical presentation, patients were classified in two groups: 1) non-autoimmune rheumatologic compromise (NARC) and 2) autoimmune rheumatologic compromise (ARC). Current ACR/EULAR criteria for classification of autoimmune diseases were used. Results Two hundred and two patients were evaluated, 80 were excluded due to negative serology for Chikungunya. 122 were included: 107 (88%) female, mean age 52.52±13.19 years, and time of evolution of 116.66±91.61 days. Acute phase. 122 patients: fever 85 (69.67%), rash and pruritus 54 (44.26%), tenosynovitis 23 (18.8%), polyarthralgias 100 (82%) and arthritis 56 (45.90%). Chronic phase. 122 patients: 71 (58%) patients had a chronic persistent rheumatologic symptoms and 51 (42%) presented remission of symptoms but all of them presented subsequent recurrence in an 91±40 days. NARC in 33 patients (27%) and ARC in 89 (73%), with no significant differences in age and time of evolution was observed. NARC: 14 (42.4%) exacerbation of previous osteoarthritis pain, 9 (27.3%) developed fibromyalgia and 10 (30.3%) had localized soft tissue pain. ARC: 13 (14.6%) with a history of RA, SLE, psoriasis or DM reactivated the underlying disease and 76 (85.4%) developed ARC: Undifferentiated polyarthritis with negative antibodies 61 (80%), RA with positive antibodies 5 (6.5%), scleroderma 2 (2.6%), cutaneous vasculitis 2 (2.6%), polymyalgia rheumatica 1 (1.3%), Sjogren9s Syndrome 2 (2.6%), Dermatomyositis 1, Erythema nodosum 1 (1.3%) and vitiligo 1 (1.3%). Antibodies were requested according to clinical suspicion: FAN ≥320 in 5 patients, RF in 6, ACPA in 4 and anti RO in 1. Thyroid dysfunction was observed in 7 patients who had a previous normal thyroid profile. Conclusions The frequency of rheumatological manifestations post Chikungunya fever in our sample was high, and can trigger ARC. Patients presenting new immunological manifestations in an endemic area for Chikungunya fever should have a serologic test performed. This series of patients must be evaluated with long-term studies to define their evolution, under the possibility of developing definite autoimmune disease or remission. References Chikungunya Pathology and Cytokines. Chow et al. JID 2011. Disclosure of Interest None declared

Background Estimated prevalence of neuropsychiatric symptoms in SLE is among 17 to 71%1. Depressive symptoms are around 54%1,2. Fatigue is frequently referred, predicts high morbidity and may be influenced by lifestyle and individual psychological characteristics1. Objectives To evaluate the prevalence of depressive symptoms and its association with demographics and clinical variables in patients with SLE. To determine the predictive value of FACIT for fatigue in SLE vs controls. Methods Observational, retrospective case- control design. Patients ≥18 years old with SLE (ACR 97) were consecutively evaluated in our centre from January to July 2015. We analyzed age, disease duration, clinical manifestations, antibodies profile, SLEDAI (≥4 scored as active) and SLICC. We recorded familiar psychiatric diseases, educational and socioeconomic level (Graffar Scale), employment and marital status. Beck II and FACIT (IV version) questionnaires were used for evaluate depression and fatigue respectively. We tested two cut points for fatigue: Results 77 SLE and 100 controls, all female. SLE vs control group: Mean of age ys: 34 (19–49)vs 38 (19–60). Prevalence of depression: 52% (44/77) vs 29% (29/100) (p 0.05). Mean disease duration (months) 48 (24–114). Socio-demographic characteristics, SLICC/SLEDAI, clinical and serological manifestations were not correlated with major depression p>0.05. FACIT: Median value: 31 (range 22–40) SLE group. FACIT Conclusions Prevalence of depression was high in our cohort and similar to previously reported1. Our patients showed low levels of SLEDAI/SLICC. There was not relation between activity levels and baseline damage with the presence of depression4. FACIT IV scale was a good independent predictor of fatigue in SLE patients with or without depression vs controls. References L Palagini M et al Depression and systemic lupus erythematosus: a systematic review. Lupus 2013. Hugo FJ et al DSM-III-R classification of psychiatric symptoms in systemic lupus erythematosus. Psychosomatics 1996. Lai JS et al Validation of the Functional Assessment of Chronic Illness Therapy-Fatigue Scale in Patients with Moderately to Severely Active Systemic Lupus Erythematosus, Participating in a Clinical Trial Journal of Rheumatology 2011. Segui J et al Psychiatric and psychosocial disorders in patients with systemic lupus erythematosus: A longitudinal study of active and inactive stages of the disease. Lupus 2000. Disclosure of Interest None declared

Background Capillary bed of labial mucosa may be a potentially useful area for assessing abnormalities on the microcirculation. Videocapilaroscopy of the labial mucosa (LVC) in 12/13 scleroderma (SCL) patients showed capillaries disturbance such as great disorganization and anarchic orientation(1). Objectives To describe LVC features in SCL and compare them with healthy controls. (HC). To compare nailfold videocapillaroscopy (NVC) with LVC in HC and SCL patients. Methods ≥16 years old patients with SCL (ACR-EULAR 2013) were included consecutively since June to July 2016. Smoking patients were excluded. For the evaluation of the LVC we performed a general displaying and then we studied following areas: a-central (1 cm from the frenulum), b-lateral right and left (both 2 cm from the frenulum) and c-labial border. For evaluation of the NVC, 200x images were obtained from 2nd to 4th fingers both hands and was classified according Cutolo in early, active, late patterns(2). For assesment through LVC: photographs (200x) for each subject were taken. We define quantitative characteristics as means of: capillary diameter, length and density. The average of these parameters was obtained from the evaluation of capillaries included in 1 mm2 of at least 2 continuous images. In addition, the visibility of the subpapillary venous plexus, architecture, dilatation of capillaries, presence of megacapillaries and avascular areas were qualitatively evaluated (photo 1). Each image was reviewed by two experienced observers. We conducted the same process describe above for each healthy control subject. Results Twenty two patients were included (18 female, age 47±11 ys) with SCL (limited 17, diffuse 5); NVC pattern: early 8, active 11, late 3. Healthy subjects 12 (11 female, age: 34±10 years). Average capillary density: 17±4.13 (13–26) in SCL vs 21±3.65 (16–28) in HC (p 0.00). Average capillary diameter: 43±13.54 (17–83) SCL vs 19±1.67 μm (16–21) HC (p 0.02). Mean capillary length: 185±34 μm (125–248) SCL vs 237±42 μm (178–313) HC (p 0.00). In 22 SCL patients were observed dilated capillaries in 20 (90%), megacapillaries (≥70 μm) in 10 (45%) and 7 (32%) showed disturbed architecture with lost areas of the normal U-shape and changes in the parallelism of the main axis of the capillaries. About subpapillary venous plexus in SCL: 7 (32%) were prominent and only one had capillary hemorrhage. In contrast, none of the controls presented these alterations. (p 0.0). According to the 3 NVC patterns the following averages were observed in the LVC: Early Pattern (n: 8): diameter 36.93±10.84 μm; Long 191.21±47.58 μm; Density 18.12±5.33 μm. Active Pattern (n: 11): diameter 48.80±14.80 μm; Length 184.11±29.91 μm; Density 16.72±3.25 μm. Late Pattern (n: 3): diameter 36.27±10; Long 178.03±28.8 μm, density 19.33±4.16 μm. Conclusions We found that LVC in SCL patients show significant microvascular changes with respect to HC. In addition, all NVC patterns described in SCL showed similar alterations in LVC. Therefore, LVC could be a complementary or alternative method to NVC since it is easily accessible, has good visibility and is not influenced by local mechanical or chemical stimuli that can affect the nail bed. References W Grassi et al. Ann Rheum Dis 1993; 52 (8): 564–569. M. Cutolo et all. Rheumatology 2006; 45: 43–46. Disclosure of Interest None declared

Background Systemic Lupus Erythematosus (SLE) may associate with flares, an unfavorable course and the need of teratogenic treatment during pregnancy. Not every contraceptive method (CM) may be used in this patients. There are guidelines for their use according to existing morbidity and SLE activity 1 . Objectives Describe the use of CM in a cohort of outpatients with SLE Methods Descriptive, observational, cross-sectional study. Patients ≥16 years old with SLE (SLICC 2012) and ≥1 visit during the last year of our database were included. Those with menopause were excluded. We analyzed demographic data; disease duration; antiphospholipid antibodies (aPL) and antiphospholipid syndrome (APS) (Sapporo 2006); socioeconomic status (Graffar scale); disease activity (SELENA-SLEDAI) and accrual damage (SLICC); use of teratogens: Methotrexate (MTX), Mycophenolate (MYC), Cyclophosphamide (CYC), biologic drugs (BD), self-reported sexual status (active/non active) and CM: intrauterine device (IUD), condom (Cdm) and hormonal contraceptive pill (CP). Results 132/219 were included. Female 91.6%, age: 30.1 (16–49) years, disease duration: 38.5 (1–324) months, SELENA-SLEDAI: 3.5 (0–29), SLICC: 0.5 (0–5). Sexual status and use of CM: were available for 120 patients. Sexually active (SA) 73%, female 77%. CM in SA patients: 74%: 5% CP, 77% Cdm and 18% IUD. CM in female patients stratified by Graffar (GF): GF I (n=1): none SA; GF II: (n=19): 84% SA, 75% of them used CM (75% Cdm, 25% IUD); GF III (n=33): 82% sexually active, 81% used CM (86% Cdm, 14% IUD), GF IV (n=41) 75% SA, 68% used CM (9% CP, 71% Cdm, 19% IUD), GF V (n=4) 100% SA, 50% used CM (50% CP, 50% Cdm); GF NA (n=11) 55% SA, 83% used CM (80% Cdm, 20% IUD). CM in female patients stratified by SLE activity: SLEDAI 12 (n=60): 60% SA, 67% used CM (100% Cdm). CM in female patients using teratogenic drugs: MTX (n=8): 100% SA, 75% of them used CM (17% CP, 66% Cdm, 17% IUD); MYC (n=20): 80% SA, 88% used CM (71% Cdm, 29% IUD); CYC (n=3): 33% SA, 100% used CM (100% Cdm); Belimumab (n=1): 100% SA, 100% surgical CM (tubectomy). aPL was evaluated in 96/132 patients. 17/96 had positive aPL and 5/17 fulfilled APS criteria. 2/17 patients had no CM data available, none with APS. 9/17 patients with aPL were female, 55% SA and all of them used Cdm. 3/5 patients with APS were female, all SA, 66% used Cdm. Conclusions Condom was the most reported CM. Use of CM was more frequent in the upper social stratus (GF I-III) respect to the lower (GF IV-V). The proportion of sexually active female patients was similar in those using teratogenic drugs compared with who had not used them. The self-reported sexual status was similar despite of SLEDAI stratification, being similar in patients with low or high disease activity. We deem necessary education, counseling and evaluation of use of the CM in every visit of patients with SLE. References Andreoli L, Bertsias GK, Agmon-Levin N, et al. Ann Rheum Dis, doi:10.1136/annrheumdis-2016–209770. Disclosure of Interest None declared