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Background: Recurrent pericarditis affects 15-30% of patients with acute pericarditis. The etiology is poorly understood, with about 80% being idiopathic. Several treatment options are available for recurrences, including NSAIDs, colchicine, glucocorticoids and IL-1 inhibitors (i.e. Anakinra). Standardized guidelines for the management of these patients are still lacking Objectives: To analyze clinical findings and treatment approach in a cohort of pediatric patients with recurrent pericarditis Methods: Patients with at least two episodes of idiopathic pericarditis, followed at two Pediatric Rheumatology centers between 2006 and 2018, were included Results: A total of 42 patients (18 males) were included. Mean age at disease onset was 11.8 years (range 4-17). Chest pain and fever were the presenting symptoms in all patients. In 47% pleural effusion was detected. Laboratory tests showed increased white blood cell count (mean 14.509/mm3), C-reactive protein (mean 18.01 mg/dl) and erythrocyte sedimentation rate (mean 39 mm/h) in all patients. The first episode was variably treated: 18/42 (43%) received NSAIDs alone, 5/42 (11.9%), colchicine alone or associated to NSAIDs and 3/42 patients (7%) received antibiotics alone. 16/42 (38%), not responsive to NSAIDs or colchicine, received glucocorticoides. Patients who received glucocorticoids at the first episode relapsed earlier (median time of 2.1 months range 10 days-5 months), than patients treated with NSAIDs (6.6 months range 10 days -24 months) or with colchicine (5 months range 10 days-5 months) (p Conclusion: Our study confirms the lack of a standardized treatment approach in patients with recurrent pericarditis. Patients treated with glucocorticoid at first episode relapse before than those treated with other drugs. Anakinra is an effective treatment; however, tapering/discontinuation of the drug lead to relapses in several cases. Further experience on larger population is needed to define the best treatment duration and approach to withdrawal of IL-1 inhibitor Disclosure of Interests: Camilla Celani: None declared, Silvia Federici: None declared, Anna Tulone: None declared, Brigitte Bader-Meunier: None declared, Virginia Messia: None declared, Manuela Pardeo: None declared, Claudia Bracaglia: None declared, Pierre Quartier Consultant for: AbbVie, Chugai-Roche, lilly, Novartis, Novimmune, Sanofi, and SOBI, Consultant for: AbbVie, Chugai-Roche, Lilly, Novartis, Novimmune, Sanofi, and SOBI, Speakers bureau: AbbVie, BMS, Chugai-Roche, Novartis, Pfizer, and SOBI, Speakers bureau: AbbVie, BMS, Chugai-Roche, Novartis, Pfizer, and SOBI, Fabrizio De Benedetti Grant/research support from: Abbvie, SOBI, Novimmune, Roche, Novartis, Sanofi, Pfizer, Antonella Insalaco: None declared

Background Coexistent auto-immune and inflammatory diseases (AIID) and sickle cell disease (SCD) have been recently described in adults and children, however its frequency and physiopathology remain unclear (1–6). Objectives The aim of this study is the analysis of clinical and biological characteristics at AIID diagnosis and the evolution under treatment in children with SCD Methods Between May 1991 and March 2018, 35 of 3,800 SCD children diagnosed with AID in seven hospitals in Paris and suburb were analyzed in a retrospective survey. Results Thirty-five patients reported 44 AIID: auto-immune liver disease (AILD, n=13), inflammatory bowel disease (IBD, n=7), juvenile idiopathic arthritis (JIA, n=6), systemic lupus erythematosus (n=5), autoimmune hemolytic anemia (n=3), Sjogren’s syndrome (n=2), histiocytic necrotizing lymphadenitis (n=2), vasculitis (n=2), myasthenia gravis (n=2), sarcoidosis (n=2), inflammatory uveitis (n=1), sclerodermia/juvenile dermatomyositis (n=1). Median age at diagnosis was 10 [2 – 18] years. The mean delay between first symptom and diagnosis was 15.5 (± 29) months. The time of diagnostic was significantly longer for patients with JIA compared to other AID (63 versus 10 days, p=0.004). Sixteen patients (45.7%) had hypergammaglobulinemia > 20 g/L at diagnosis. AILD had a hypergammaglobulinemia at the time of diagnosis (30.0g/L), with a statically significant decrease at the end of follow-up (18.2g/L, p=0,0048). Among 21 patients (60%) treated with systemic steroids, it triggered vaso-occlusive crisis in 14 (66.7%), one acute chest syndrome, one transient ischemic attack. Thirteen of 35 patients (37.1%) were managed with biotherapy for AIID, well tolerated. Three patients (8.6%) underwent stem cell transplantation, one died of a cortico-resistant and multipolar graft versus host reaction, two were cured of both AIID and SCD. Nine severe infections were reported, four under steroids, five under biotherapy. Conclusion Diagnosis and therapeutic care of coexistent auto-immune and inflammatory diseases are difficult and challenging in children with SCD. Annual monitoring of inflammatory markers could be recommended to detect AIID earlier and prevent diagnostic delay in case of high ascension in SCD patients. References [1] Li-Thiao-Te V, Uettwiller F, Quartier P, et al. Coexistent sickle-cell anemia and autoimmune disease in eight children: pitfalls and challenges. Pediatr Rheumatol Online J. 17 janv 2018;16(1):5. [2] Cherner M, Isenberg D. The overlap of systemic lupus erythematosus and sickle cell disease: report of two cases and a review of the literature. Lupus. juin 2010;19(7):875–83. [3] Adelowo O, Edunjobi AS. Juvenile idiopathic arthritis coexisting with sickle cell disease: two case reports. BMJ Case Rep. 1 dec 2011;2011. [4] Michel M, Habibi A, Godeau B, Bachir D, Lahary A, Galacteros F, et al. Characteristics and outcome of connective tissue diseases in patients with sickle-cell disease: report of 30 cases. Semin Arthritis Rheum. dec 2008;38(3):228–40. [5] Galmiche S, Amiot X, Georgin-Lavialle S, et al. Maladies inflammatoires chroniques de l’intestin chez des patients atteints de syndrome drepanocytaire majeur: a propos de 6 cas. Disponible sur: http://www.em-premium.com.frodon.univ-paris5.fr/article/1122766/resultatrecherche/34 [6] Jitraruch S, Fitzpatrick E, Deheragoda M, et al. Autoimmune Liver Disease in Children with Sickle Cell Disease. J Pediatr. oct 2017;189:79-85.e2. Disclosure of Interests Caroline Vinit: None declared, Corinne Guitton: None declared, Patricia Benhaim: None declared, Florence Missud: None declared, Mariane De Montalembert: None declared, Lahoueri Amor: None declared, Cecile Arnaud: None declared, Oussama Charara: None declared, Vincent Gajdos: None declared, Veronique Hentgen Consultant for: SOBI, Novartis, Abbvie, Speakers bureau: Novartis, Annie Kamdem: None declared, Sylvie Nathanson: None declared, Brigitte Bader-Meunier: None declared, isabelle melki: None declared, Isabelle Kone-Paut Grant/research support from: SOBI has supported drug product (anakinra) for the presented study, Consultant for: SOBI, Novartis, Pfizer, Abbvie, UCB, CHUGAI, ROCHE, Pierre Quartier Consultant for: AbbVie, Chugai-Roche, lilly, Novartis, Novimmune, Sanofi, and SOBI, Consultant for: AbbVie, Chugai-Roche, Lilly, Novartis, Novimmune, Sanofi, and SOBI, Speakers bureau: AbbVie, BMS, Chugai-Roche, Novartis, Pfizer, and SOBI, Speakers bureau: AbbVie, BMS, Chugai-Roche, Novartis, Pfizer, and SOBI, Loic De Pontual: None declared, Luu-Ly Pham: None declared

Background Juvenile dermatomyositis (JDM) is a rare heterogeneous autoimmune disease. The identification of myositis specific antibodies (MSAs) has allowed the characterization of subgroups of JDM patients who each have specific phenotypes. Antibody (Ab) against transcriptional intermediary factor-1-γ (TIF-1-γ or p155/140) is the most common MSA in JDM 1. In the American and English JDM cohorts, anti-TIF-1-γ associated JDM is classically associated with a larger proportion of caucasians, mild or moderate severity with typical cutaneous manifestations (Gottron’s papules, and/or heliotrope rash, photosensitivity), and a chronic disease course with a low mortality. The frequency of skin ulcerations and lipodystrophy differs between the two cohorts Objectives To report the clinical and muscle histology associations of anti-TIF-1-γ Ab in a series of patients with JDM followed in the French referral center for rare pediatric systemic autoimmune diseases. Methods Retrospective study of patients with JDM (according to the EULAR/ACR criteria) associated with anti-TIF-1-γ autoantibodies and included in our CEMARA database approved by the French National Committee on Informatics and Liberty. Results Thirteen patients were included (males: 5, females: 8; Caucasians: 6, Black Africans: 2, North Africans: 5). Age at diagnosis ranged from 1.5 to 11 years. Serum creatine kinase was elevated in 12 patients (range: 180-43 000 IU/L). Three different phenotypes were identified according to the severity and course. In group 1 (n=4), 3 patients had a moderate JDM: classical cutaneous manifestations and moderate muscle involvement; relapsing course, which remitted under methotrexate/corticosteroids; an additional 2-year-old girl had an amyopathic JDM. In group 2 (n=7), patients had a severe JDM : ulcerating skin lesions, severe muscle involvement, dysphagia, gastrointestinal vasculitis and/or requirement to an intensive care unit, and required more than two lines of treatment. In this group, 2/7 patients died from refractory JDM, comparing to a mortality rate of 2% in the remaining JDM patients tested for MSA and negative for anti-TIF-1-γ. Only 2/5 patients achieved a complete remission under treatment. Group 3 comprised two patients with severe muscle atrophy, calcinosis and lipodystrophy and a chronic course; one of them had a very-early-onset JDM at 1.5 year-old and the other an inherited neurological involvement, potentially suggestive of a genetic predisposing condition to JDM. None of the patients developed lung involvement or malignancy. Six patients underwent a muscle biopsy which was scored using the JDM severity score tool. The histo-pathologists’ overall severity score (VAS) varied from to 1 to 9/10; the highest scores were observed in the two patients who died. Conclusion In the present series of patients with JDM, TIF-1-γ Ab-associated-clinical phenotypes and ethnicities are more heterogeneous than previously reported. TIF-1-γ Ab is associated with a high mortality rate in a subset of patients. References [1] Rider LG, Nistala K. The juvenile idiopathic inflammatory myopathies: pathogenesis, clinical and autoantibody phenotypes, and outcomes. J Intern Med. 2016;280(1):24-38 Disclosure of Interests Brigitte Bader-Meunier: None declared, cyril gitiaux: None declared, jean-luc charuel: None declared, Nicole Fabien: None declared, isabelle melki: None declared, Pierre Quartier Consultant for: AbbVie, Chugai-Roche, lilly, Novartis, Novimmune, Sanofi, and SOBI, Consultant for: AbbVie, Chugai-Roche, Lilly, Novartis, Novimmune, Sanofi, and SOBI, Speakers bureau: AbbVie, BMS, Chugai-Roche, Novartis, Pfizer, and SOBI, Speakers bureau: AbbVie, BMS, Chugai-Roche, Novartis, Pfizer, and SOBI, alexandre belot: None declared, Nathalie Streichenberger: None declared, christine bodemer: None declared, audrey aussy: None declared, olivier boyer: None declared

Background: Pediadiatric-onset systemic lupus (pSLE) is a severe mulisystem autoimmune condition which mostly manifests after the age of 10 years. It is mainly a polygenic disorder, but a mutation in a single gene may predispose to the developementof SLE (« monogenic lupus »). We will describe some unusual presentations which may lead to a delayed diagnosis or misdiagnosis and provide clues for the diagnosis of monogenic lupus. Objectives: To discuss the difficult diagnosis and pitffalls in pSLE Results: The most common initial manifestations of pSLE are cutaneous, musculoskeletal, renal, hematologic, and fever. Howerver, atypical symptoms may reveal the diagnosis or occur during the course of SLE. In a French retrospective study1, thirty-two percent of children had atypical symptoms, mainly including abdominal involvement in 26 patients, which lead to negative laparotomy for presumed appendicitis before the diagnosis of SLE could be established. Abdominal pain was related to lupus pancreatitis or peritonitis. The diagnosis of pSLE should be systematically searched for in a teenager who presents with unexplained mood disorders, psychosis or depression, which may reveal pSLE. In a patient with a suspected diagnosis of neuropsychiatric pSLE, underlying factors including infections, hypertension, metabolic abnormalities or adverse effects of medication should be excluded before considering a luous-related neurological involvement2. Finally, the diagnosis of pSLE should be also considered in case of severe complications such as macrophage activation syndrome or alveolar hemorrhage. Monogenic SLE should be suspected in early-onset SLE ( Conclusion: The diagnosis of pSLE should be suspected in teenagers with acute unexplained symptoms, especially in case of abdominal pain or neuropsychiratric involvement. A monogic predisposition to SLE should be considered in early-onset SLE, especially in patients with SLE family history, consanguinity, recurrent infections, and/or encephalopathy with spasticity. References: [1] Bader-Meunier B, Armengaud JB, Haddad E, et al. Initial presentation of childhood-onset systemic lupus erythematosus: a French multicenter study. J Pediatr. 2005;146(5):648-53. [2] Groot N, de Graeff N, Avcin T, et al. European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus: the SHARE initiative. Ann Rheum Dis. 2017;76(11):1788-1796 Disclosure of Interests: None declared

Background Juvenile dermatomyositis (JDM) is a rare and heterogeneous children-onset idiopathic inflammatory myopathy. It primarily affects skeletal muscle and skin, but also pulmonary, cardiac and gastrointestinal systems in a subset of patients. Gastrointestinal (GI) involvement occurs in 22 to 37% of JDM patients and have been described only in a few case reports. Objectives To describe causes of severe abdominal manifestations in JDM patients. Methods Retrospective monocentric study. Inclusion criteria were (i) diagnosis of JDM according to the modified Bohan and Peter criteria before 16 years of age, (ii) occurrence of severe involvement of any intra-abdominal organ, (iii) follow-up at Necker Hospital from 2005 to 2018. Severe abdominal manifestation was defined as a potential life-threatening abdominal organ event, need for abdominal surgery and/or parenteral nutrition. Gastrointestinal (GI) involvement was defined by severe abdominal pain, dysphagia, digestive hemorrhage, obstruction, ulceration and/or perforation. Severe hepatitis was defined by an elevation of liver enzymes exceeding five times the upper limit associated with an elevation of γ-glutamyl transferase (γGT) activity and/or liver failure. Abdominal manifestations were classified as certain or probable primary JDM involvement, therapy-related event or infection-related event. Results Nine patients with 19 abdominal complications were identified among 110 JDM patients followed during the study period (8,3%). Diagnosis of JDM was made at a median age of 10.7 years-old [range, 3.7 – 14.4], with a median CMAS of 7 [range, 2 – 48], median MMT of 47 [range, 38 – 76], a median creatine kinase level of 3 812 UI/L [range, 170 – 14 054], and a median follow-up of 3 years [range, 0.4 – 6.3]. Seven patients were positive for either anti-NXP2 (n = 4), anti-TIF1-γ (n = 2) or anti-MDA5 (n = 1) antibodies. JDM-related abdominal disease comprised GI involvement (n = 10), acute pancreatitis (n = 4) and hepatitis (n = 3). The revealing symptom for GI involvement and acute pancreatitis was abdominal pain. Five patients with severe abdominal pain, vomiting and/or obstruction, underwent abdominal imaging revealing thickening of colon (n = 2) and/or ileum mucosa (n = 2). Hepatitis was found in 3 patients with an uncommon extensive steatosis with moderate inflammation and perisinusoidal fibrosis (n = 2). Treatment-related complications were considered certain for methotrexate-induced liver toxicity (1 patient) and possible for duodenal perforations (1 patient) 3 days after a methylprednisolone pulse. At last visit, JDM was clinically inactive in four patients. Three patients died from refractory JDM, 2.9 years [range, 2 – 3.6] after the JDM diagnosis, among the 9 patients identified in this study versus only 1/92 of the other JDM patients from our cohort. Conclusion Primary JDM involvement was the main cause of severe abdominal manifestations and associated to a high mortality rate. We highlight for the first time that pancreatitis should be considered as a main diagnosis in JDM patients who develop severe and/or sustained abdominal pain. Disclosure of Interests Caroline Besnard: None declared, cyril gitiaux: None declared, Muriel Girard: None declared, Louise Galmiche-Rolland: None declared, Cecile Talbotec: None declared, Pierre Quartier Consultant for: AbbVie, Chugai-Roche, lilly, Novartis, Novimmune, Sanofi, and SOBI, Consultant for: AbbVie, Chugai-Roche, Lilly, Novartis, Novimmune, Sanofi, and SOBI, Speakers bureau: AbbVie, BMS, Chugai-Roche, Novartis, Pfizer, and SOBI, Speakers bureau: AbbVie, BMS, Chugai-Roche, Novartis, Pfizer, and SOBI, Laureline Berteloot: None declared, christine bodemer: None declared, Brigitte Bader-Meunier: None declared

Background Tocilizumab (TCZ) is a humanized monoclonal antibody that blocks interleukin 6. In children, TCZ has been approved for the treatment of systemic-onset and polyarticular course juvenile idiopathic arthritis (JIA), and is used off-label in other treatment refractory inflammatory diseases. Real-world data regarding tolerance of TCZ in children are scarce. Objectives To assess the incidence rate and type of serious adverse events in children treated with TCZ. Methods A single-center retrospective review of all consecutive patients receiving TCZ in the pediatric rheumatology division from 01/2007 to 12/2018 was performed. Inclusion criteria were a diagnosis of inflammatory rheumatic disease and treatment with at least one dose of TCZ. Patients with missing data were excluded. Serious adverse events (SAE) were defined as a life-threatening event and/or an event requiring hospital admission, leading to permanent disability or treatment discontinuation. Results A total of 70 children (39 females) were included. Thirty children had systemic JIA, 25 polyarticular course JIA, 14 systemic inflammatory disorders such as autoinflammatory syndromes and one patient severe refractory idiopathic uveitis. Median age at diagnosis was 4.2 years (IQR 2.0 – 7.3). The majority of children had received prednisone (n=56), and/or at least one biologic agent (n=63) prior to TCZ initiation. At TCZ start, children had a median age of 8.9 years (IQR 4.9 – 12.3) and disease duration of 3.2 years (IQR 0.9 – 7.4). TCZ was initiated at a 2-weekly interval in 44 children, 26 children received TCZ every 4 weeks. Fifty-eight children received concomitantly another immunosuppressive agent (prednisone (n=47) and/or methotrexate (n=20) and/or various other drugs (n=5)). A median of 26 TCZ doses were given per child (IQR 7 – 48), TCZ exposure was 146.8 patient years. Twenty-two SAE were observed in 18 (26%) children (SAE 14.9/100 patient years): 8 severe infusion reactions, 7 serious infections, 3 cutaneous reactions (toxic reaction, cutaneous vasculitis, scleroderma-like skin thickening with fasciitis), two macrophage activation syndromes, and one abnormal hepatic function and severe dizziness each. Infusion reactions occurred most frequently during the first few infusions (median during 4th infusion, IQR 3 – 5). All patients with infusion reactions had either systemic JIA (n=4) or another autoinflammatory disease (n=4). At time of infusion reaction, all children (8/8) had active disease, 7/8 had a concomitant treatment with prednisone and 2/8 additionally with cyclosporine. At last follow up, 35 (50%) children were still on TCZ, the other 35 had discontinued TCZ: 4 for remission, 13 because of inefficacy, 12 because of side effects, 3 because of both inefficacy and side effects, and 3 for other reasons. No death occurred during TCZ treatment; two patients with systemic inflammatory disease, in whom TCZ had been inefficient, died from uncontrollable disease 13 and 15 months after TCZ discontinuation, respectively. Conclusion In this cohort, serious adverse events were observed in a quarter of children with half of them having severe infusion reactions. Higher incidence rates of severe infusion reactions were observed in children with systemic JIA or autoinflammatory diseases. Ongoing careful monitoring of patients treated with TCZ, especially those with important systemic inflammation is required. Disclosure of Interests Florence Aeschlimann: None declared, Andreas Worner: None declared, Richard Mouy Consultant for: Honoraries received by Roche for Tocilizumab trial in children, Carine Wouters Grant/research support from: Grant/research support to Istituto Gaslini from GlaxoSmithKline immune-inflammation: unrestricted grant to study Blau syndrome; Roche: unrestricted rese

Background Juvenile Dermatomyositis (JDM) is a rare, autoimmune and highly heterogeneous paediatric-onset myopathy, characterized by skin and muscles inflammation. Development of vasculopathy is associated with the severe extra-muscular manifestations of JDM, and portends a poor prognosis. Impaired function of JDM vasculature includes immune complex and complement deposition. Objectives The aim of our study is to describe the clinical and paraclinical phenotype of patients with anti-factor H autoantibody (Ab) associated with JDM and overlap myositis. Methods Patients with a diagnosis of JDM or overlap myositis and presence of anti-FH auto-antibody, followed in two Parisian tertiary centers over the last twelve years, were retrospectively selected. Besides demographic data, clinical features (cutaneous lesions, severity of muscle involvement, extra-muscular manifestations), treatment options and their outcome were retrieved for each patient. Biological data and presence of myositis-specific autoantibodies were collected, muscle MRI were examined, and data from muscle biopsies were assessed using a validated score tool when available. Results Eleven female patients were included in the study, with a median age at diagnosis of 8.8 years [2.8 – 13.1], and a median follow-up of 3 years [1 – 11.7]. Apart typical cutaneo-muscular presentation, seven developed calcinosis, and six presented with subcutaneous oedema (of which 5 were anti-NXP2 positive). Median CMAS was 24/52 [1 – 47], and median MMT was 52/80 [2 -76]. Gastro-intestinal involvement was found in 10 patients (91%), 4 presented a pulmonary impairment, and 3 girls had psychiatric symptoms. Six patients had a severe form (54%), one of them led to death (after 2.8 years of evolution). MSA were found in 9 patients (anti-NXP2 = 1, anti-fibrillarine = 2, anti-MDA5 = 1 and anti-TIF1gamma = 1). IFN-signature was positive in 9 patients. Complement exploration was normal in all patients, and median positive rate of Anti-Factor H Ab was 260 UA/L [115 – 2800]. Muscle biopsy was performed in all patients but one with a median total score severity of 20. All patients received corticosteroids, and one to six other lines of treatment to achieve remission, obtained in 8 patients, with a median time to remission of 2 years [0.5; 4.8]. Use of plasmapheresis/immunoadsorption and/or Ruxolitinib was necessary in 3 of them (27%). Conclusion Presence of anti-factor H auto-antibodies in JDM or overlap myositis patients seems associated with more frequent gastro-intestinal involvement, and a more severe phenotype, requiring more aggressive treatment. References Disclosure of Interests None declared

Background Juvenile idiopathic arthritis (JIA) may lead to structural damage. Yet radiographic assessment is seldom considered in studies. Objectives To provide pragmatic guidelines concerning conventional radiography (CR) in each subtype of JIA (exclusion of systemic JIA). Methods A multidisciplinary task force of 15 French experts (rheumatologists, pediatricians, radiologists) plus one patient9s representative, was convened. Following the GRADE1 method, they formulated a series of research questions concerning CR assessment, at diagnosis and follow-up of each subtype of JIA. Systemic JIA was ruled out. A systematic literature review was conducted, considering articles in which structural damage was detailed (erosion, joint space narrowing, bone deformities). A series of recommendations was elaborated, following evidence-based data, and expert opinion. It underwent an evaluation from an independant committee (including patient9s representative), and a final round of Delphi-voting process from the whole expert group. Results Of 646 publications identified, 73 original articles were included. The task force produced 4 principles and 31 recommendations. Level of evidence ranked from B to D, level of agreement was high. The experts insisted on weighing indication of CR considering structural risk. The importance of assessing structural progression, the need for constant attention to radioprotection were asserted. Systematic CR of hands and feet are thus recommended in polyarthritis JIA rheumatoid factor positive, and in polyarticular JIA with pejorative prognostic factors. Systematic CR are not recommended in oligoarticular JIA. CR is not the prime imaging technique of the axial skeleton. Conclusions These are the first pragmatic recommendations upon CR in JIA. They mostly rely on experts9 opinion, due to lack of evidence-based data. CR is still relevant in many situations in JIA, but should not be overlooked, while non-irradiating imagine techniques are developing. References Brozek JL, Akl EA, Compalati E, Kreis J, Terracciano L, Fiocchi A, et al. Grading quality of evidence and strength of recommendations in clinical practice guidelines part 3 of 3. The GRADE approach to developing recommendations. Allergy. 2011 May;66(5):588–95. Acknowledgements Dr Bouchra Amine, Pr Nathalie Boutry, Pr Rolando Cimaz, Pr Bernard Combe, Dr Veronique Despert, M William Fahy and Mrs Celine Obert (association KOURIR), Dr Laurence Goumy, Pr Michael Hofer, Dr Laetitia Houx, Dr Sylvie Jean, Dr Valerie Merzoug, Pr Michel Panuel, Pr Samira Rostom, Pr Jean Sibilia; the French Society for Rheumatology, the French Society for Radiology, The French Society for Pediatric and antenatal Imaging. Disclosure of Interest None declared