Search

Introduction: SLS is a rare manifestation (0.6-13.5%) of SLE. It is suspected in patients with dyspnea and pleuritic pain, diaphragmatic elevation in thoracic images and a restrictive ventilatory defect. Objectives: Describe the clinical, radiological and functional features of a cohort of patients diagnosed with SLS; as well as its evolution in pulmonary function tests. Methods: A retrospective and descriptive review of the clinical histories of the patients diagnosed with SLS treated in the pulmonary and rheumatology division was conducted between 2009 and 2018. Demographic, clinical, functional, radiological, and treatment data were collected. Results: Out of a total of 225 patients diagnosed with SLE, 10 (4.44%) with SLS diagnosis were included. Mean age was 41.2 + - 16 years; 6 (60%) were women. The main symptom was dyspnea in 70 (70%). Two patients (20%) presented pleuritic pain. 9 (90%) presented decreased lung volumes and 5 (50%) laminar atelectasis. The mean FVC was 1.95l + -0.44 (50.5%); TLC 3.31l + - 0.47 (62.1%); DLCO 16.78 + -4.24 (68.2%); KCO (DL/VA) 5.62 + -1.28 (128%); maximal inspiratory pressure (MIP) 70.4 + -25.4 (72.6%); maximal expiratory pressure (MEP) 90.7 + -56.3 (84.6%). Corticosteroid treatment was used in 10 (100%) of the patients, associated with azathioprine in 3(30%). The mean FVC value after a median time of 27 months was 2.28 (58%); an improvement of 300 ml (7.7%) compared to the first FVC measurement was observed. Conclusions: The prevalence of SLS was 4.4%. The median time to diagnosis of SLS was 30 months. With the immunosuppressive treatment, a respiratory functional improvement was achieved.

Background Systemic Lupus Erythematosus (SLE) is an autoimmune disease in which inflammation is mediated by complement activation by immune complex deposit, leading to damage. Consumption of C3 and C4 complement fragments is accepted as a disease activity marker. The aim ofthis study is to describe clinical and serologic characteristics of SLE patients according to complement levels. Methods Our SLE electronic database was analyzed (Jan 2014–Aug 2016). We included patients 18 years, fulfilling ACR 1997/SLICC 2012 classification criteria, with at least one year follow-up and at least two complement levels determinations at different times during follow-up. Patients were classified in 4 groups, defined as following: Group 1 (normal C3 and C4 on all determinations), Group 2 (C3 and C4 below reference levels on all determinations), Group 3 (only C4 below reference levels on all determinations) and Group 4 (C3 and/or C4 on variable levels, with at least one determination below reference levels). Demographic data, disease activity by SELENA-SLEDAI, accrual damage by SLICC-DI, presence of anti DNAds and anti Sm antibodies and clinical manifestations were assessed. Statistical analysis was performed using Epi info v7. Correlation was assessed using chi2 or Fisher’s test appropriate. Results 149 patients were included. 95.3% female, mean age at diagnosis was 30.6 years (CI: 28,5 32,8), mean disease duration 9.7 years. Mean SLICC-DI by group: Group 1 1.0, Group 2 0.5, Group 3 1.3 and Group 4 0.6. All groups with hypocomplementaemia showed a higher SLEDAI respecting Group 1 (p=0.0013)(table 1) Presence of anti DNAds and anti Sm antibodies is shown in table 1. Respecting clinical manifestations, a significant difference was found in Lupus Nephritis (Group 1 36.8%, Group 2 44.1%, Group 3 78.6% and Group 4 36,4% (p=0.0002)) and hemolytic anemia (Group 3 28.6% and Group 1 17.6% (p: 0.0196))(table 1). Conclusions An association between C4 persistently below reference levels (Group 4) and anti DNAds antibodies and Lupus Nephritis was found. Group 3 patients may have a worse prognosis due to renal involvement. Complement levels during follow up could be used as a marker to assess nephritis risk in SLE patients. Funding Source(s): None

Background The idiopathic inflammatory myopathies (IIM) are rare systemic autoinmune diseases that affect the muscle and other organs. Ttraditionally, IIM encompasses polymyositis (PM) and dermatomyositis (DM), but progressively inclusion body myositis (IBM), Immune-mediated necrotising myopathy (IMNM), the antisynthetase syndrome (ASS) and connective tissue diseases-ovler myositis (CTD-OM) have been recognised within the IIM spectrum Objectives To compare the clinical characteristics and treatment in a IIM cohort from an Argentinian universitary hospital with the international IIM cohort EUROMYOSITIS Methods Descriptive, retrospective study. IIM patients defined by expert opinion followed in our centre between October 2007 and October 2017 were included. ASS was defined by the presence of arthritis, raynaud’s phenomenon, mechanic hands, elevated CK, muscle weakness, interstitial lung disease and/or presence of antisynthetase antibodies and, as in EUROMYOSITIS, patients with IIM with positive antisynthetase antibodies were reclassified as ASS. CTD-OM was defined as patients with IIM fulfilling classification criteria for other CTD. Demographic data, accumulated clinical features, time interval between disease onset and diagnosis, IIM subtype, treatment and presence of neoplasm were evaluated. Ethnicity was defined using the same classification as in EUROMYOSITIS Results 58 patients were included: DM 24, PM 4, ASS 10, CTD-OM 20. 89.6% Hispanic, mean age 48.4±15.2 years, median time interval between disease onset and diagnosis 5 months (IQR 2–11 months), been higher in AAS (8.5 months, IQR 1.5–18.2 months). 6,89% (4/58) patients presented associated neoplasm, 3 with DM and 1 with CTD-OM. Table 1 shows the demographic and clinical features of our IIM cohort and EUROMYOSITIS. Table 2 shows treatments received in our cohort and EUROMYOSITIS. Conclusions DM was the most frecuent IIM subtype in both cohorts. In our group, CTD-OM was second and ASS was third. Muscle weakness was found less frecuently in our DM and AAS than reported in EUROMYOSITIS. However, calcinosis was more frecuent. This could be explained by our mostly Hispanic population and/or by frecuent Systemic Sclerosis overlap in our patients. It’s important to remark that the ethnic variety defined as Hispanic in EUROMYOSITS has a complex composition in Latin America, due to interbreeding. No difference was found in therms of most frecuent treatments between both cohorts. However, use of IVIg was more frecuent in our patients. To our knowledge, this is the first comparative report of an argentinian single-centre IIM cohort and an international multi-centre cohort 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 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

Background Systemic lupus erythematous (SLE) have an increase cardiovascular risk, worsened by overweight and obesity. Increased BMI is associated with other severe complications and comorbidities as lupus nephritis, hypertension, insulin resistance and dyslipemia. Body weight is a modifiable risk factor. Objectives To determine the frequency of overweight and obesity in patients with SLE and their impact on this disease Methods Descriptive, cross-sectional study. We reviewed the medical records of outpatients with SLE (ACR 1997) who were seen since 2014 to 2016 in the Clinical Hospital of Buenos Aires, Argentina. We evaluated sex, age, disease duration, obstetric history, use and doses of oral corticosteroids, BMI, 25 OH vitamin D and educational level. Disease activity was scored by SLEDAI. Scores ≥4 were classified as active. The patients were classified into 2 groups, according to BMI: normal weight (NW) (19–25), overweight and obesity (≥25). Results One hundred and sixty two of 230 were evaluated. Sixty-eight patients were excluded due to lack of data. 157 (97%) were women. Mean age for both sexes was 40.6±14.3 years (p 0.70). Means of: SLEDAI 4.3±4.47 (54.9% had SLEDAI ≥4), IMC: 27.04±5.22 (56% had a BMI ≥25) and 25-hidroxivitamin D was 25.15±9.0. Relation between 2 groups, according to BMI: 84.5% whom were in NW group have received steroids at some point vs 95.6% in BMI≥25 group (p 0.02). Mean steroids doses: BMI ≥25: 9.53±10.98 vs 5.0±7.2 in NW group (p 0.04). Multivariate analysis showed that BMI ≥25 continued significantly associated with SLE duration, independently of the steroids use and other variables. 25 OH vitamin D tended to be lower in BMI ≥25 vs NW, but no significant differences (24.53±9.91 vs 25.50±9.85) (p=0.071) Conclusions Over a half of our cohort had BMI ≥25 and was characterized by older age, more frequent menopause, longer course of the disease, increased steroid use and lower educational level. Depression and hypertension were the statistically more frequent comorbidities found. Obesity was associated with more activity and accrual damage including chronic renal disease. Disclosure of Interest None declared