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ObjectiveTo evaluate the relevance of salivary gland ultrasound (SGUS) and its place in the diagnostic algorithm in patients referred with dry syndrome (DS) for a suspicion of Sjögren’s syndrome (SS).MethodsWe included all patients assessed at our dedicated DS clinic from June 2015 to September 2019 for which a SGUS has been carried out. Images were read blindly and the worst salivary gland was scored according to OMERACT classification. Clinical features, disease activity and treatments were collected.Results337 patients were seen from June 2015 to September 2019. 269 patients underwent SGUS. 77 patients were diagnosed with SS and 192 did not meet the ACR/EULAR criteria for SS: non-Sjögren’s DS (NSDS). Of these 192 patients, 60 had another possible cause of DS, and 132 patients were diagnosed with SAPS (sicca, asthenia, polyalgia syndrome).SGUS abnormalities were significantly higher in patients with SS versus NSDS: 51% vs 8% for a score ≥2 (pConclusionSGUS is useful for SS diagnosis. If anti-SSA antibodies are negative and SGUS score

Objective To assess post-discharge persistent symptoms and health-related quality of life (HRQoL) of patients hospitalized in a COVID-19 ward unit more than 100 days after their admission. Methods All eligible patients were contacted by phone by trained physicians and were asked to answer to a dedicated questionnaire. Patients managed in hospital ward without needing intensive care were compared with those who were transferred in intensive care units (ICU). Results We included 120 patients after a mean (±SD) of 110.9 (±11.1) days following admission. The most frequently reported persistent symptoms were fatigue (55%), dyspnoea (42%), loss of memory (34%), concentration and sleep disorders (28% and 30.8%, respectively). Comparisons between ward- and ICU patients led to no statistically significant differences regarding those symptoms. In both group, EQ-5D (mobility, self-care, pain, anxiety or depression, usual activity) was altered with a slight difference in pain in the ICU group. Conclusion Most patients requiring hospitalization for COVID-19 still have persistent symptoms. While there were few differences between HRQoL between ward and ICU patients, our findings must be confirmed in larger cohorts, including more severe patients.

Resume Les mucopolysaccharidoses (MPS) constituent un groupe de maladies de surcharge lysosomale rares, comprenant un grand nombre d’affections polymorphes, chacune liee a une mutation particuliere responsable du deficit d’une des enzymes impliquees dans la degradation des glycosaminoglycanes, aboutissant a leur accumulation tissulaire. La plupart d’entre elles sont diagnostiquees chez l’enfant ou l’adolescent et sont de mauvais pronostic en raison de l’atteinte viscerale, et ne sont par consequent pas vues par le rhumatologue adulte. Il existe cependant des formes moderees lentement progressives, avec une atteinte musculosquelettique au premier plan et une esperance de vie proche de celle de la population generale. Ces formes cliniques attenuees sont plus susceptibles d’etre diagnostiquees a l’âge adulte, apres plusieurs annees, voire plusieurs decennies d’evolution et d’errance diagnostique. En effet, l’expression clinique de ces pathologies mime parfois celle des rhumatismes inflammatoires chroniques, ce qui engendre un retard diagnostic. La reconnaissance et le diagnostic de ces formes attenuees de mucopolysaccharidoses sont difficiles en raison des manifestations cliniques moderees et/ou non-specifiques, telles que des douleurs ou des raideurs articulaires. Il est donc important que les rhumatologues soient sensibilises a reconnaitre ces affections. Le diagnostic precoce est essentiel, puisque des therapeutiques specifiques telles que le traitement par enzymotherapie substitutive sont actuellement disponibles selon le type de MPS et peuvent, lorsqu’instaurees precocement, ralentir la progression des lesions tissulaires qui sont malheureusement irreversibles. Cet article a pour objectif de passer en revue les principales caracteristiques cliniques et radiographiques, les strategies diagnostiques et l’actualisation de la prise en charge, qui doit etre validee de facon multidisciplinaire par les experts d’un centre labellise de reference. Le role du rhumatologue prend ici toute son importance tant pour la surveillance des symptomes que pour la prevention des complications.

Joint Bone Spine - In Press.Proof corrected by the author Available online since vendredi 31 aout 2018

International audience; Mucopolysaccharidoses are a group of rare lysosomal storage diseases including a great number of polymorph syndromes, each being related to a particular mutation responsible for a deficiency of glycosaminoglycan degrading enzymes, leading to an accumulation of glycosaminoglycans in tissues. Many of them are diagnosed in children or teenagers and have a severe prognosis because of organ failure, and are consequently usually not seen by the adult rheumatologist. However, some of them have a more progressive presentation, with musculoskeletal symptoms at the forefront and a lifespan that nearly reaches that of the general population. These milder forms are more likely to be diagnosed in adults, in patients who have suffered for years and sometimes even decades with unrecognized mucopolysaccharidosis. Indeed, they can sometimes mimic inflammatory rheumatic disorders, and therefore be misdiagnosed for a long time. Recognition and diagnosis of these attenuated forms can be a real challenge as they lead to moderate and/or nonspecific symptoms such as joint pain or stiffness. Hence, rheumatologists should know about them. Early diagnostic is essential since specific treatment, like enzyme replacement therapy, is now available for some subtypes and might, if given early, slow down the development of tissue damage, which is unfortunately irreversible. This article provides the opportunity to review the main clinical and radiographic features, the diagnostic strategy and the update of management, which should be multidisciplinary and led by an experienced physician in a reference centre. The contribution of the rheumatologist is important to ensure symptom control and prevent complications.