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Galectins, a family of animal lectins, play central roles in immune system regulation, shaping both innate and adaptive responses in physiological and pathological processes. These include rheumatoid arthritis (RA), a chronic multifactorial autoimmune disease characterized by inflammatory responses that affects both articular and extra-articular tissues. Galectins have been reported to play central roles in RA and its experimental animal models. In this perspective article we present new data highlighting the regulated expression of galectin-1 (Gal-1) and galectin-3 (Gal-3) in sera from RA patients under disease-modifying anti-rheumatic drugs (DMARDs) and/or corticoid treatment in the context of a more comprehensive discussion that summarizes the roles of galectins in joint inflammation. We found that Gal-1 levels markedly increase in sera from RA patients and positively correlate with erythrocyte sedimentation rate (ERS) and disease activity score 28 (DAS-28) parameters. On the other hand, Gal-3 is downregulated in RA patients, but positively correlates with health assessment questionnaire parameter (HAQ). Finally, by generating receiver-operator characteristic (ROC) curves, we found that Gal-1 and Gal-3 serum levels constitute good parameters to discriminate patients with RA from healthy individuals. Our findings uncover a differential regulation of Gal-1 and Gal-3 which might contribute to the anti-inflammatory effects elicited by DMARDs and corticoid treatment in RA patients. Fil: Mendez Huergo, Santiago Patricio. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Hockl, Pablo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Stupirski, Juan Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Maller, Sebastian Matias. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Morosi, Luciano Gastón. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Pinto, Nicolás Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina Fil: Berón, Ana M.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina Fil: Musuruana, Jorge L.. Provincia de Santa Fe. Ministerio de Salud. Hospital J. B. Iturraspe; Argentina Fil: Nasswetter, Gustavo Guillermo. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina Fil: Cavallasca, Javier A.. Provincia de Santa Fe. Ministerio de Salud. Hospital J. B. Iturraspe; Argentina Fil: Rabinovich, Gabriel Adrián. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina

Introduction No inherent renal lesions are known in rheumatoid arthritis (RA), but urinary abnormalities and renal dysfunction have been described. Objective First, we describe the histopathological findings of renal biopsies (RBs) in patients with RA and associated clinical manifestations. Second, we evaluated time evolution of RA and the relationship between drugs and renal disease. Last, we investigate whether changes in the management of RA from 1976 to 2015 influenced RBs indication, frequency, and type of histopathological findings. Patients and methods This is a retrospective and observational study conducted at a university hospital from Argentina. Patients with a diagnosis of RA (ACR, 1987) and RBs between 1976 and 2015 were included. Sixty-five patients met the inclusion criteria. The histopathological findings and associated clinical manifestations were evaluated. Time evolution of RA and the relationship between drugs and renal disease were also determined. To clarify these issues, we characterized 3 groups according to changes in the management of RA: 1976-1989, 1990-2002, and 2003-2015. Results The most common histopathological finding was renal amyloidosis in 31% (n = 20), followed by mesangial glomerulonephritis in 18% (n = 12), membranous nephropathy in 17% (n = 11), extracapillary proliferative glomerulonephritis in 15% (n = 10), focal segmental glomerular sclerosis in 9% (n = 6), minimal change nephropathy in 5% (n = 3), and tubulointerstitial nephritis in 5% (n = 3). Time evolution of renal amyloidosis was significantly higher than other RBs (15 ± 12 vs 7 ± 6.5 years). Nephrotic syndrome was the most common clinical manifestation (60%) followed by hematuria (46%) with or without proteinuria. Membranous nephropathy was related to the use of gold salts in 45% of cases, and its frequency decreased since 1990. Before 2003, renal amyloidosis was the leading cause of kidney disease, but mesangial glomerulonephritis reached the same frequency between 2003 and 2015. We found that RBs decreased 20% in the second period (1990-2002) and 40% in the last period (2003-2015). Nephrotic syndrome remained the main RB indication during the entire study period. Conclusion This is the first report on RBs findings in patients with RA from Latin America. We found a significant reduction in RBs frequency and modified histological patterns throughout the study period, although RB indication was not modified. Changes in the management of RA might have influenced these findings.

Objective.To define whether Amerindian genetic ancestry correlates with clinical and therapeutic variables in admixed individuals with rheumatoid arthritis (RA) from Latin America.Methods.Patients with RA (n = 1347) and healthy controls (n = 1012) from Argentina, Mexico, Chile, and Peru were included. Samples were genotyped for the Immunochip v1 using the Illumina platform. Clinical data were obtained through interviews or the clinical history.Results.Percentage of Amerindian ancestry was comparable between cases and controls. Morning stiffness (p < 0.0001, OR 0.05), rheumatoid factor (RF; p < 0.0001, OR 0.22), radiographic changes (p < 0.0001, OR 0.05), and higher number of criteria were associated with lower Amerindian ancestry after Bonferroni correction. Higher Amerindian ancestry correlated only with weight loss (pBonferroni < 0.0001, OR 2.85). Increased Amerindian ancestry correlated with higher doses of azathioprine (p < 0.0001, OR 163.6) and sulfasalazine (p < 0.0001, OR 48.6), and inversely with methotrexate (p = 0.001, OR 0.35), leflunomide (p = 0.001, OR 0.16), and nonsteroidal antiinflammatory drugs (pBonferroni = 0.001, OR 0.37). Only the presence of RF and weight loss were modified after confounders adjustment.Conclusion.Amerindian ancestry protects against most major clinical criteria of RA, but regarding the association of RF with increased European ancestry, age, sex, and smoking are modifiers. Ancestry also correlates with the therapeutic profiles.

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

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

Background Systemic sclerosis (SS) is an autoimmune disease with generalized vascular dysfunction and a myriad of clinical and laboratory manifestations. Spreading of thickening of the skin, serological characteristics and the pattern of compromise of the internal organs help to classify them as diffuse scleroderma, localized sclerosis and systemic sinus scleroderma. Reports of Latin American cohorts published to date are scarce. Objectives To describe the clinical and serological data for a single center cohort and to compare those with national and international cohorts. Methods Descriptive, observational, cross-sectional study. We analyzed our SS database. Patients were evaluated since 01/15 to 05/2016 and fulfilled SS classification criteria (ACR 1980/ACR-EULAR 2013).Patients were classified according to Le Roy criteria in Limited Systemic Sclerosis (lSS), Diffuse Systemic Sclerosis (dSS), Systemic Sclerosis sine scleroderma (SsnS) and pre-systemic sclerosis (pSS). Organic compromise was defined as follows: Gastrointestinal (GI): esophagic dismotility by manometry or esophagitis by endoscopy; Lung: Pulmonary hypertension (PH): PSAP>25 mmHg by right heart catheterization; Intersticial Lung Disease (ILD): compatible HRCT or Results 123 patients were included.74% with lSS,24% dSS and 2% SsnS; age at diagnosis (years): 49.7 (18–79 DS: 12.27) and 48.7 (27–79 DS: 13.01) in lSS and dSS respectively. Raynaud9s phenomenon previous to diagnosis (years) 7,7 (0–54 DS: 12.81) in lSS and 4.03 (0–22 DS: 5.5) in dSS. 49.5% lSS were ACA positive vs 17% in dSS as well also 41,4% had Scl-70 positive (p Conclusions Our data showed similar results to the local and european cohorts. We found fewer calcinosis and digital tip ulcers in both lSS and dSS than international cohorts. A lower prevalence of PH was reported in lSS respect to other series, and it might be atributed to the method wich it was measured. (right heart catheterism). Disclosure of Interest None declared

Background and Aims Systemic Lupus Erythematosus (SLE) and its treatment predispose to infections such as human papillomavirus (HPV) that is a risk factor for the development of lower genital tract (LGT) and anal cancers. To assess LGT- anal lesions, frequency of HPV lesions and premalignant and malignant lesions. Methods Descriptive, cross-sectional design. Women with SLE (ACR 1997) of Argentina were consecutively sent to examination of the LGT and high-resolution anoscopy (2010–2015). Biopsies were performed according to gynaecological criteria and patient consent (Bethesda). Koilocytic cells were associated with HPV. Three Socioeconomic status (SES) groups were established (Graffar). EditorResults 73 SLE patients and 104 healthy control were included. Table 1: Demographics characteristics. SLE patients 25/73 (34.3%) had HPV versus 6/104 (5.8%) in the control group (p=0.00). In the SLE-HPV were found statistically significant differences in: low SES, sexual partners≥5, antiDNA+ and low complement and a trend to low educational level (p=0,07). At check data the average dose of steroids was 10.8 Mg/d (SLE-HPV) vs 2.9 Mg/d in without HPV (p=0.00) while 61% (HPV group) vs 29% (without HPV) were receiving immunosupressors (IS) (Table 2) Non-differences were found related to duration of SLE, smoking, beginning of sexual intercourse, condom use and anal or oral intercourse. Conclusions The frequency of HPV was high in women with SLE. We remark oligo/asymptomatic HPV and its association with low SES, serological activity and treatment. As we detected a high frequency of sole anal lesions we highlight the anoscopy regardless of symptoms.

Objective To identify susceptibility loci for rheumatoid arthritis (RA) in Latin American individuals with admixed European and Amerindian genetic ancestry. Methods Genotyping was performed in 1,475 patients with RA and 1,213 control subjects, using a customized BeadArray containing 196,524 markers covering loci previously associated with various autoimmune diseases. Principal components analysis (EigenSoft package) and Structure software were used to identify outliers and define the population substructure. REAP software was used to define cryptic relatedness and duplicates, and genetic association analyses were conducted using Plink statistical software. Results A strong genetic association between RA and the major histocompatibility complex region was observed, localized within BTNL2/DRA–DQB1– DQA2 (P = 7.6 × 10−10), with 3 independent effects. We identified an association in the PLCH2-HES5-TNFRSF14-MMEL1 region of chromosome 1 (P = 9.77 × 10−6), which was previously reported in Europeans, Asians, and Native Canadians. We identified one novel putative association in ENOX1 on chromosome 13 (P = 3.24 × 10−7). Previously reported associations were observed in the current study, including PTPN22, SPRED2, STAT4, IRF5, CCL21, and IL2RA, although the significance was relatively moderate. Adjustment for Amerindian ancestry improved the association of a novel locus in chromosome 12 at C12orf30 (NAA25) (P = 3.9 × 10−6). Associations with the HLA region, SPRED2, and PTPN22 improved in individuals positive for anti–cyclic citrullinated peptide antibodies. Conclusion Our data define, for the first time, the contribution of Amerindian ancestry to the genetic architecture of RA in an admixed Latin American population by confirming the role of the HLA region and supporting the association with a locus in chromosome 1. In addition, we provide data for novel putative loci in chromosomes 12 and 13.

A common feature between patients with a certain group of systemic autoimmune pathologies (SAPs) with rheumatic component, such as lupus erythematosus (LE) in all its forms, is the presence of cutaneous photosensitivity (CP) as well as the existence of autoantibodies (Aabs). These Aabs have also high incidence in other SAPs that do not present CP, like primary Sjögren's syndrome and rheumatoid arthritis. Cutaneous photosensitivity is a condition that consists of an exacerbated skin reaction to solar radiations; its incidence can reach 90% in systemic LE. The mechanisms involved in the development of CP have been extensively studied focusing on different approaches; however, the exact mechanism has not been fully elucidated yet. There are many theories that relate specifically the presence of circulating anti-Ro/SS-A Aabs with the CP phenomenon, though there are several studies which are in disagreement. In this study, we evaluated the Aabs profile (anti-Ro/SS-A 52 kDa, anti-Ro/SS-A 60 kDa, anti-La/SS-B, anti-Sm and ANAs) as well as their titer or reactivity, in a local cohort of 169 patients with SAPs. We related those Aabs profiles and titers with the presence or absence of CP, and we found that there was no significant association between the presence of anti-Ro/SS-A Aabs and the occurrence of CP. On the other hand, a statistically significant positive association was found between CP and high reactivity anti-Sm Aabs, though this fact could be biased by the incidence of both events in SLE patients. To sum up, in the particular population studied, there is no direct relationship between anti-Ro/SS-A Aabs and CP, which is in agreement with some authors and in disagreement with many others, contributing to the endless discussion of this issue.

Henoch-Schonlein Purpura (HSP) is a systemic vasculitis mediated by IgA and characterized by the clinical triad of non-thrombocytopenic palpable purpura, abdominal pain, and arthritis. In addition, there may be varying degrees of renal involvement. It is the most frequent vasculitis in children and the incidence in adults varies from 3.4 to 14.3 cases per million, depending upon the experimental series analyzed.1 We report the onset, course and response to treatment of five adult patients who required hospitalization at our institution between 2002 and 2006 (all fulfilled the 1990 American College of Rheumatology (ACR) criteria).2 Case 1 A 24-year-old white male with frequent episodes of pharyngitis was admitted for an eight day course of palpable purpuric lesions on his lower limbs, arthritis in both ankles, and diffuse abdominal pain. A complete blood count with differential analysis, liver function test, coagulation test, chemistry panel, and ERS were normal. A urinary sediment showed dysmorphic hematuria with 30 to 40 red blood cells/high power field and proteinuria of 2.29 g / 24 hr. A skin biopsy of the lower limbs showed leukocytoclastic vasculitis. IgA and C3 deposits were observed upon immunofluorescent assay. The renal biopsy indicated mesangial nephropathy due to IgA deposition (Figure 1). Figure 1 Renal biopsy with mesangial IgA deposition (inmunofluorescence, 200X) The patient began treatment with IV methylprednisolone, 1 g/day for 3 days, and continued with oral prednisone, 40 mg/day. During treatment, the patient presented an increase in proteinuria (3.12 g/day), the persistence of dysmorphic hematuria, and developed hypertension. He was therefore treated with IV cyclophosphamide, 1g/m²/month for six months, and enalapril, 10 mg/day. Both blood and urine laboratory parameters stabilized after the first pulse of cyclophosphamide.

Introduction Several studies have shown that Hispanic patients generally experience a worse renal prognosis than non-Hispanic white patients with lupus. To date, there is no report on American College of Rheumatology (ACR) renal response criteria (ACR-RRC) in patients from Latin America. Objective To evaluate treatment response in patients with proliferative and membranous lupus nephritis (LN) according to ACR-RRC. Methods A retrospective study (2001–2011) was performed in our hospital and the data collected included clinical information, renal assessment and immunological parameters. Details related to treatment received during induction and maintenance therapy were also recorded. Results The study included forty-three Latin American patients (37 women) from Argentina. Mean follow-up was 54 months. The regimen used for induction therapy included intravenous cyclophosphamide (IV-CYC) for six months in 36 patients and only seven received mycophenolate mofetil (MMF) given twice daily for a total dose of 2.5 ± 0.5 grams a day. For the maintenance period, six patients continued with quarterly IV-CYC, 20 patients received MMF (1.5 ± 0.5 grams a day) and 17 patients received azathioprine (AZA) 1.5 – 2 mg/kg/day. ACR-RRC observed after induction therapy was complete response in 19%, partial response in 9%, improvement in 42%, unchanged in 14%, and 16% had deterioration despite treatment. ACR-RRC observed after maintenance therapy was complete response in 30%, partial response in 23%, improvement in 19%, unchanged in 16%, and 12% had deterioration. Relapse was observed in 11 patients (25%). Ten out of 11 cases (91%) who relapsed did not achieve a complete response at the end of the induction therapy. Conclusion In Latin American patients from Argentina, only 19% could achieve a complete response after induction therapy and 30% achieved a complete response after maintenance therapy. Failing to obtain a complete response after induction therapy was related to an increased risk of relapse during long-term follow-up in our study.

La paquidermoperiostosis u osteoartropatía hipertrófica primaria es una rara enfermedad caracterizada por compromiso cutáneo y osteoarticular. Comunicamos dos casos que presentaban hipocratismo digital, uñas en vidrio de reloj, agrandamiento óseo, tumefacción articular y diferentes grados de afectación cutánea, sin otros hallazgos clínicos relevantes. Ambos desconocían antecedentes familiares similares. El estudio radiográfico de las zonas comprometidas mostró periostosis. Con resultados de laboratorio y radiografía de tórax normales, y ausencia de evidencia clínica de otra enfermedad subyacente, se realizó diagnóstico de osteoartropatía hipertrófica primaria.Pachydermoperiostosis or primary hypertrophic osteoarthropathy is a rare disease characterized by cutaneous and osteo-arthicular involvement. We describe two patients with finger clubbing, watch crystal nails, bones thickenings, arthritis and different grades of skin affection, without other clinical manifestations. Both did not know of having relatives with the same alterations. Radiological studies of the affected areas showed periostosis. Because of normal laboratory results and chest radiography plus the absence of other underlying causes, diagnosis of primary hypertrophic osteoarthropathy was made.

Introduction Infections are the leading cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Invasive fungal infections (IFI) comprise a group of diseases caused by Cryptococcus, Histoplasma, Aspergillus and Candida. Few studies of IFI have been published in patients with SLE and associated factors have not been completely defined. Objectives The objectives of this paper are to estimate the frequency of IFI in admitted patients with SLE in our hospital, to determine the risk factors associated with IFI in our patients with SLE, and to compare IFI group with a control group (SLE without IFI). Methods The medical charts of patients with IFI (EORTC/MSG, 2008) and SLE (ACR, 1997) admitted to our hospital from June 2001 until June 2012 were reviewed. To identify factors associated with IFI, we developed a case-control study (SLE + IFI vs SLE alone) in a one to three ratio adjusted for sex and age and hospitalization for other reasons. Comparison was made of demographic characteristics, duration of disease and disease activity previous to IFI diagnosis, especially three months before fungal infection. We defined severe activity as SLEDAI ≥ 8. Infection by fungi of the genus Candida was considered only in its disseminated form. Results Ten cases of IFI were identified in 208 patients with SLE admitted between June 2001 and June 2012. We included 40 patients with SLE (10 with IFI and 30 controls). Of the SLE-IFI patients, eight were women and the average age was 27.5 years (range, 19–42 years). Fungal isolation: eight Cryptococcus neoformans, one Histoplasma capsulatum and one Candida albicans. Sites affected: five in peripheral blood, five in central nervous system (CNS), four in skin/soft tissue and one in pleura. Mortality was 40% ( p = 0.002), with Cryptococcus neoformans being the most common fungus. The SLE disease activity was severe in 70% of infected patients and no significant difference with the control group was found ( p = 0.195). We also found no association with leukopenia, lymphopenia, hypocomplementemia, hypogammaglobulinemia or anti-DNA positivity; neither with meprednisone doses >20 mg/day or intravenous methylprednisolone pulse therapy before fungal infection. The use of immunosuppressive therapy with azathioprine showed a significant association ( p = 0.017). Cyclophosphamide ( p = 0.100) or mycophenolate mofetil ( p = 0.256) did not show similar results. Conclusion The frequency of IFI in hospitalized SLE patients in our hospital was 4.8%. Cryptococcus neoformans was the most common etiologic agent and was primarily responsible for the deaths in this cohort. These data are consistent with publications in East Asia rather than North America where Candida spp. is more common. Unlike other publications, previous immunosuppression with azathioprine was the only risk factor associated with the development of the infection. Invasive fungal infection should be suspected in hospitalized patients with SLE and immunosuppression with CNS or atypical cutaneous manifestation of SLE in order to start appropriate treatment early and obtain better outcome.

To identify susceptibility loci for rheumatoid arthritis (RA) in Latin American individuals with admixed European and Amerindian genetic ancestry.Genotyping was performed in 1,475 patients with RA and 1,213 control subjects, using a customized BeadArray containing 196,524 markers covering loci previously associated with various autoimmune diseases. Principal components analysis (EigenSoft package) and Structure software were used to identify outliers and define the population substructure. REAP software was used to define cryptic relatedness and duplicates, and genetic association analyses were conducted using Plink statistical software.A strong genetic association between RA and the major histocompatibility complex region was observed, localized within BTNL2/DRA-DQB1- DQA2 (P = 7.6 × 10(-10) ), with 3 independent effects. We identified an association in the PLCH2-HES5-TNFRSF14-MMEL1 region of chromosome 1 (P = 9.77 × 10(-6) ), which was previously reported in Europeans, Asians, and Native Canadians. We identified one novel putative association in ENOX1 on chromosome 13 (P = 3.24 × 10(-7) ). Previously reported associations were observed in the current study, including PTPN22, SPRED2, STAT4, IRF5, CCL21, and IL2RA, although the significance was relatively moderate. Adjustment for Amerindian ancestry improved the association of a novel locus in chromosome 12 at C12orf30 (NAA25) (P = 3.9 × 10(-6) ). Associations with the HLA region, SPRED2, and PTPN22 improved in individuals positive for anti-cyclic citrullinated peptide antibodies.Our data define, for the first time, the contribution of Amerindian ancestry to the genetic architecture of RA in an admixed Latin American population by confirming the role of the HLA region and supporting the association with a locus in chromosome 1. In addition, we provide data for novel putative loci in chromosomes 12 and 13.

The purpose of the following study was to analyze maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus (SLE) and the influence of SLE exacerbations on those pregnancies. Seventy-two pregnancies in 61 SLE patients treated between January 1986 and February 2004 in Hospital de Clínicas "José de San Martin" were reviewed retrospectively. Patient age was 28.1 +/- 6.2 years (mean+/-standard deviation [SD]). Mean SLE duration was 4.5 +/- 3.2 years (range 6 months-10 years). No patient acquired the disorder during gestation. Four (5.5%) patients had signs of active disease at the beginning of her pregnancy. Sixteen patients, accounting for 20 pregnancies, had a history of lupus nephritis. Nine patients met secondary antiphospholipid syndrome criteria and had 13 pregnancies. There were 14 exacerbations of the disease during pregnancy (19.4%), with most flares being mild. The most common obstetric complications were gestational hypertension in 15 pregnancies (20.8%) and preeclampsia in 8 pregnancies (11%). Forty-six percent of pregnancies ended in preterm deliveries. There were 62 live births (1 twin birth; 85%), 6 stillbirths (8%), and 5 spontaneous abortions (7%). Thirty-nine percent of newborns had low birth weight. Adequate pregnancy follow-up and delivery care by an interdisciplinary team in Argentine SLE patients with no pre-gestational preparation resulted in maternal and fetal outcomes similar to those seen in world reference centers.

In systemic lupus erythematosus (SLE), the respiratory system is frequently compromised. One of its uncommon manifestations is the shrinking lungs syndrome (SLS), characterised by dyspnoea, diaphragmatic elevation and a restrictive pattern in the spirometry. We report two cases affected with this rare entity. They presented with different degrees of respiratory involvement and responses to the therapy. At the same time, clinical, physiopathological, prognostic and therapeutic aspects of this syndrome are reviewed.

Pachydermoperiostosis or primary hypertrophic osteoarthropathy is a rare disease characterized by cutaneous and osteoarthicular involvement. We describe two patients with finger clubbing, watch crystal nails, bones thickenings, arthritis and different grades of skin affection, without other clinical manifestations. Both did not know of having relatives with the same alterations. Radiological studies of the affected areas showed periostosis. Because of normal laboratory results and chest radiography plus the absence of other underlying causes, diagnosis of primary hypertrophic osteoarthropathy was made.

Viscosuppplementation with intra-articular hyaluronic acid (hyaluronan [HA]) is a relatively new option for improving pain and articular function in patients with symptomatic knee osteoarthritis. An open multi-center study was performed in 365 patients with definite and symptomatic knee osteoarthritis from seven Latin American countries. Five doses of HA were administered once a week. The parameters studied were pain (six items), stiffness (two items) and functional capacity (17 items). The parameters were evaluated 1 week after the corresponding injection. Statistical differences were found when basal determinations of the three parameters were compared with the results of the first and fourth administration (p0.05). Intra-articular HA administration was well tolerated. Treatment-related nonserious adverse events were registered in 2.5% of administrations. Based on the results obtained, HA is a useful and well-tolerated symptomatic treatment for knee osteoarthritis with a rapid onset of action.

A white female patient developed overlapping features of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) with severe pulmonary compromise. She was treated with steroids and azathioprine, which improved her clinical condition and spirometric status. In May 2002 she presented with continuous pain in her left ankle that continued even during rest and under treatment with nonsteroidal anti-inflammatory drugs (NSAIDs). Magnetic resonance imaging (MRI) showed multiple avascular necrosis (AVN). Rest and kinesitherapy were indicated for 1 year, and gradually an orthosis was introduced allowing the patient to walk normally.

Background Several observational studies have shown a high prevalence of periodontitis (PO) in patients with rheumatoid arthritis (RA) compared with the general population. Moreover, the presence of PO in RA was associated with higher disease activity according to some authors. Based on these studies, it has been postulated that the PO may be a risk factor for the onset and progression of RA. Objectives 1. To estimate the prevalence of PO in RA patients from our hospital (RA-PO[+]); 2. To estimate severity of PO in RA patients; 3. To establish whether there were significant differences between median value of DAS28-ESR score between RA-PO[+] group versus PO[-] group; 4. To establish whether there were significant differences between the median value of HAQ score between RA-PO[+] group versus PO[-] group; 5. To establish whether there were significant differences between the median score of DAS28-ESR and HAQ between patients with and without PO receiving biological therapy. Methods Patients diagnosed with RA (ACR/EULAR, 2010) from our hospital were prospectively included. Personal history, medication received (including biological therapy), presence or absence of rheumatoid factor (RF) and anti-citrullinated peptide antibody (anti-CCP) was recorded. The disease activity was assessed by DAS28- ESR and functional ability by HAQ questionnaire. The periodontal assessment was conducted by specialized dentists in immunosuppressed patients evaluating the presence and severity of PO. The median test was used to compare scores to describe the data and percentages were used in mean and SD, median and range according to the measurement scale of variables. For inferential measures, such measures with their corresponding confidence intervals were accompanied. Results One hundred RA patients (94 women and 6 men) were included. The average age was 55.8 years (range 17-80 years) and the average time of evolution was 11.52 years (range 0-43 years). RF was available in 93 patients, being positive in 73 (78.5%) and anti-CCP was positive in 67 of 78 patients (85.9%). The prevalence of PO in RA patients was 44% [95%CI 34.20-54.26]; also, it was mild in 22% [95%CI 14.58-31.6], moderate in 14% [95%CI 8.14-22.71], severe 8% [95%CI 2.69-23.02]. There was no statistically significant difference in the mean value of DAS28-ESR score between the RA-PO[+] versus RA-PO[-] group ( p =0.145). Furthermore, no statistically significant differences was found in HAQ value between RA-PO[+] versus RA-PO[-] group ( p =0.22). In total, 24 patients were treated with biological therapy (infliximab=3; adalimumab=4; etanercept=11; abatacept=1; tocilizumab=4) and we did not observe statistically significant differences between the median score of DAS28-ESR and HAQ in patients with and without PO receiving this treatment (p=0.67). Conclusions The prevalence of PO obtained in our study is higher than that estimated in the general population ( Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.6058

Background Rheumatoid Arthritis (RA) is a chronic inflammatory disease that affects 1% of the world9s population. Patients with RA are at increased risk of cardiovascular disease (CVD) and they have lower survivals rates than the general population mainly due to an accelerated atherosclerosis caused by inflammatory mechanisms. Periodontitis (PO) is frequent in patients with RA and is also associated with systemic inflammation. The coexistence of both processes could potentiate the cardiovascular impact of RA. Objectives The purpose of this study was to evaluate systolic and diastolic cardiac function by echocardiography and tissue Doppler imaging in patients with RA with and without PO. Methods Patients with diagnosis of RA (ACR/EULAR, 2010) were included. Exclusion criteria were atrial fibrillation and known structural heart disease of any etiology. All patients underwent odontologic evaluation, 2D echocardiography, echo-Doppler and tissue Doppler imaging following recommendations of the American Society of Echocardiography. Patients were classified into 3 groups according to the presence of PO (G1: no PO, G2: mild PO, G3: moderate/severe PO). Categorical variables were compared with χ 2 test and continuous variables were compared with ANOVA. A p Results Seventy-two patients with RA (mean age 55±13 years, 96% female) were included. Forty one patients were classified in G1, 16 in G2 and 15 in G3. There were no significant differences in age, prevalence of cardiovascular risk factors, anthropometric measures and time since diagnosis of RA between groups. G3 had a higher prevalence of male sex (G3: 20%, G1: 0% and G2: 0%; p=0,002). Table 1 shows the main results of echocardiographic evaluation. There were no significant differences between groups in structural, systolic or dyastolic parameters. Conclusions In this cohort of patients, periodontitis was not associated with structural or functional heart changes as assessed by comprehensive echocardiographic evaluation. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.6069

Background Rheumatoid Arthritis (RA) is a chronic inflammatory disease that affects 1% of the world9s population. Patients with RA are at increased risk of cardiovascular disease (CVD) and they have lower survivals than the general population mainly due to an accelerated atherosclerosis caused by inflammatory mechanisms. The early detection of subclinical CVD could allow a more aggressive treatment of risk factors. Objectives The purpose of this study was to analyze systolic and diastolic cardiac function by echocardiography and tissue Doppler imaging in patients with RA as well as to compare them with a control group. Methods Eighty two patients with RA (ACR/EULAR, 2010) and 17 of the control group were studied. Patients with atrial fibrillation, diabetes and known structural heart disease of any etiology were excluded. A 2D echocardiography, echo-Doppler and tissue Doppler were achieved following the recommendations of the American Society of Echocardiography. Categorical variables were compared with χ 2 test while the continuous ones were compared with the T test. A p Results Seventy-five patients with RA (mean age 55±13 years, 95% female) and 16 controls (mean age 51±18 years, 88% female) were included. Median time from diagnosis of RA 10.7 (±9.2) years. There were no differences in sex, age, prevalence of cardiovascular risk factors, arterial pressure and anthropometric measures between the two groups. Patients with RA had greater left atrium dimensions, higher systolic pulmonary pressure and higher E/e ratio in both ventricles than the control group. On the contrary, patients with RA had a lower tricuspid and mitral systolic annular plane excursion and a lower systolic left ventricular tissue Doppler velocity. In the following table we describe the most relevant findings. Conclusions Presence of premature disturbances in both systolic and diastolic heart function was found in RA patients compared with control group. Early detection of patients at increased risk of coronary artery disease would allow early treatment and improved survival. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.6060

Background Atherosclerotic cardiovascular disease (ACVD) is the leading cause of death worldwide. Carotid atherosclerosis is one of its manifestations and can be assessed noninvasively by ultrasound. Systemic inflammation is a risk factor for developing ACVD. Rheumatoid arthritis (RA) and periodontitis (PO) are associated with the development of systemic inflammation and ACVD, however the role of the PO is controversial as potential confounders such as smoking and diabetes are independent risk factors for both PO to ACVD. Objectives To evaluate whether moderate or severe PO is independently associated with the presence of carotid atherosclerotic disease in patients with RA. Methods An observational, cross-section study was performed. Patients diagnosed with RA (ACR/EULAR 2010) in ambulatory monitoring were included. We excluded those with known cardiovascular disease (heart attack, stroke, heart failure and valvular disease). All participants underwent a clinical evaluation, laboratory tests, dental evaluation and carotid Doppler ultrasound (measurement of intima-media thickness and detection of atheromatous plaques) according to the recommendations of the American Heart Association. The population was divided into 2 groups (G1: with moderate or severe PO and G2: no PO or mild PO). For the analysis of categorical variables, Chi 2 was used (or Fisher exact correction as necessary) and for continuous variables Student test was applied. In all cases a P value less than 0.05 was considered significant. Multivariate analysis was performed using logistic or linear regression as was applicable for adjusting for sex, age, smoking, and diabetes, among other variables. Results Seventy two patients with RA were included, mean age 54.8 (±3.6) years, 93.9% female, median time from diagnosis of RA 10.7 (±9.2) years. Thirty-one patients (43.1%) had PO. Fifteen patients (20.8%) belonged to the G2. G2 patients had a trend to older age but did not reach statistical significance (60.7±10.2 vs 53.2±14.3, P=0.054) and higher prevalence of males (20% vs 0%, P Conclusions In this cohort of patients with rheumatoid arthritis, the presence of moderate or severe periodontitis was not associated with the presence of carotid atheromatous lesions. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.6065

Background The SF36 is a generic 36 items questionnaire which measures eight dimensions of health status, and permit to make direct comparisons with other disease states or with population norms. SF36 reflects a combination of physical and mental function, and well-being, the extent of social and role disability, and patients personal evaluation of health status. It has been used in several countries and its contents and construct validity, test retest reliability and responsiveness have also been reported. Objectives to evaluate the health related quality of life (HRQoL) of patients affected by rheumatoid arthritis (RA) through SF36, and to correlate the results with ACR core set activity index and with mHAQ disability index. Methods The study included 121 consecutive patients affected by RA attending the “Hospital de Clinicas”, mean age 50(18-84) years, mean disease duration 91(3-480) months, erythrocyte sedimentation rate (ESR)34.71(8-105) mm/h, and mean mHAQ 0.68(0-3). The HRQoL was evaluated through SF36(100-0) eight domains, physical function (PF), physical role (PR), bodily pain (BP), general health (GH), vitality (V), social function (SF), emotional role (ER), and mental health (MH). Disease activity was assessed using ACR core set, swollen joint count (SJcount 0-28), tender joint count (TJ count 0-28), pain by visual analogue scale (VAS 0-100), patient global assessment by VAS, physician global assessment by VAS, acute phase reactant erythrocyte sedimentation rate (Westergren, mm/h), and disability by mHAQ(0-3). Results The mHAQ showed good correlation with PF, BP(r > 0.61), SF(r > 0.55), and correlated with PR, V(r > 0.47). VAS pain correlated well with BP and V(r > 0.60), and correlated with PF, PR, and GH(r >o.41), patients global assessment correlated with BP, GH, V(r > 0.48). All correlations had p Conclusion SF36 showed to be a practical tool for use in RA patients and may facilitate to achieve burden of impact of disease and to compare with that of other chronic diseases. In this cohort mHAQ was significantly associated with physical and social function as well as bodily pain and vitality. VAS patients global assessment was associated with general health, vitality and bodily pain. No correlation were found with physical and mental role suggesting that different information is involved. Differences with others RA cohorts may be due to demographic characteristics and medical conditions in our group.

Background ACR and EULAR guidelines recommend performing renal biopsy in every SLE patient with proteinuria above 0,5g/24h. Some patients show an active urine analysis with dysmorphic erythrocytes but proteinuria Objectives To analyzed clinical manifestations, SLEDAI and histological classes found in patients with SLE and proteinuria Methods Retrospective study of 33 adult patients with SLE (ACR 1997) and proteinuria We analyzed clinical manifestations and SLEDAI at the time of renal biopsy. All renal samples were studied by light microscopy and immunofluorescence and were classified according to the ISN RPS 2003. Data were analyzed using SPSS 17.0 program. Results There were 25 women (76%) and 8 men (24%), average age of 34 years (19-65) IQR 17. Median of disease: 120 months (36-264) IQR 96. Cutaneous involvement was found in 28 patients (84.8%), arthritis in 21 (63.6%), hematological features in 17 (51.5%), serositis in 9 (27.3%), and no patient had neurological criteria. Anti DNA was positive in 24 patients (72.7%) and hypocomplementemia 20 (60.6%). Mean SLEDAI was 15 (DS 6.06). Conclusions We found high prevalence of proliferative forms in SLE patients with low proteinuria ( References George K Bertsias et al, Joint European League Against Rheumatism and European Renal Association–European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis, Ann Rheum Dis 2012;71:1771–1782. Hahn BH et al, American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis, Arthritis Care Res 2012 Jun; 64(6):797-808. Sociedad Argentina de Reumatologia y Sociedad Argentina de Nefrologia, Primer Consenso Argentino sobre Diagnostico y Tratamiento de la Nefropatia Lupica, Rev Arg Reumatol. 2011; 22 (4): 06-37. Disclosure of Interest : None Declared

Sudden death following steroid pulse therapy has been recently reported. Continuous electrocardiographic recording was performed 24 hours before, during, and 24 hours after each one to three high dose intravenous methyl prednisolone pulses administered of five patients with severe ankylosing spondylitis unresponsive to conventional therapy. No increase in supraventricular or ventricular arrhythmias was observed. Bradyarrhythmias, conduction disturbances or ischemic changes were not found. Cardiovascular symptoms did not occur in any case; there were no significative changes in any of the clinical controls. Transient elevations of serum glucose were observed in all patients. Although a transient increase in potassium and decrease in sodium urinary excretion was noted, serum levels remained within normal values.