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Resumen La evolucion de la artritis idiopatica juvenil de inicio sistemico (AIJs) hacia las diferentes formas de presentacion de enfermedad inflamatoria intestinal es extremadamente infrecuente. Presentamos la que, hasta ahora, es la primera comunicacion de un paciente con AIJs con evolucion a enfermedad de Crohn en el que se han detectado mutaciones en genes responsables de la adecuada regulacion del sistema inmune innato.

Background Cutaneous manifestations have been included in COVID-19 patients’ clinical spectrum. Our objective was to determine the association between skin lesions in children and SARS-CoV2 infection, analyzing others possible infectious/autoimmune etiologies. Material and methods Observational, multicenter, cross-sectional study, about children with skin manifestations from April to May 2020. The diagnosis of SARS-CoV2 was performed by PCR in nasopharyngeal exudate and/or presence of antibodies by serology. Results Sixty-two children were included, 9 (14.5%) presented positive antibodies to SARS-CoV-2, with no positive PCR to SARS-Cov-2 in those patients in whom it was made. Patients with positive serology to SARS-CoV-2 presented chilblains and/or vesicular-bullous skin lesions more frequently (66.7% vs. 24.5%, p = 0.019). Generalized, urticarial and maculopapular rash was more common in patients with negative antibodies (37.7 vs. 0%, p = 0.047), others pathogens were isolated in 41.5% of these patients. There were no significant differences in the positivity for autoantibodies between both groups. Conclusion In our study, the presence of chilblains-like and/or vesicular lesions were significantly related to SARS-CoV2 previous contact.

Resumen El sindrome antifosfolipido catastrofico es una entidad infrecuente en Pediatria, pero con importante relevancia dada la elevada morbimortalidad. Se expone el caso de un nino con isquemia digital en el que, tras realizar despistaje etiologico de diferentes entidades infecciosas e inflamatorias, se llego al diagnostico de sindrome antifosfolipido catastrofico primario.

Catastrophic antiphospholipid syndrome is an infrequent disease in children, but of major relevance because of its high morbidity and mortality. We report the case of a child with digital ischaemia in whom, after aetiological screening, the diagnosis of catastrophic antiphospholipid syndrome was made.

Introduction: In 2014 the Consensus Document produced by the Spanish Paediatric Societies (SEIP-SERPE-SEOP) was published to help in the diagnosis and treatment of osteoarticular infections (OAI). In 2015 the RIOPed was considered as a multidisciplinary national network for the investigation into OAI. The aim of this study was to assess the level of adaption to the recommendations established in the Consensus during one year of follow-up. Material and methods: A prospective, national multicentre study was carried out in 37 hospitals between September 2015 and September 2016. The study included patients >16 years-old with a diagnosis of OAI, confirmed by microbiological isolation, or probable: septic arthritis (SA) with >40,000 white cells in synovial fluid, or osteomyelitis (OM)/spondylodiscitis (SD) with a compatible imaging test. The results were compared with those obtained in a retrospective study conducted between 2008 and 2012. Results: A total of 235 cases were included, of which 131 were OM, 79 SA, 30 OA, and 15 SD. As regards the complementary tests that the Consensus considered mandatory to perform, radiography was carried out on 87.8% of the cases, a blood culture on 91.6%, and culture of the synovial fluid in 99% of SA. A magnetic resonance (MR) was performed on 71% of the OM cases. The choice of intravenous empirical antibiotic treatment was adapted to the recommendations in 65.1% of cases, and in 62.3% for the oral treatment. Surgery was performed in 36.8% of SA cases (85.7% arthrotomy), with a significant decrease compared to the retrospective study (P = .014). Only 58.5% of cases followed the recommendations on the duration of the treatment; however, a lower duration of intravenous treatment was observed. Conclusions: In general, the level of adaptation to the recommendations that were set by the Expert Group, is good for the complementary tests, and acceptable as regards the choice of antibiotic treatment, although inadequate in almost 40% of cases. A decrease in hospital stay was achieved. Resumen: Introducción: En 2014 se publicó el Documento de Consenso desarrollado por SEIP-SERPE-SEOP para el diagnóstico y el tratamiento de las infecciones osteoarticulares (IOA). En 2015 se constituyó RIOPed como red nacional multidisciplinar para la investigación en IOA. El objetivo del estudio ha sido valorar el grado de adecuación a las recomendaciones establecidas en el consenso durante un año de seguimiento. Material y métodos: Estudio prospectivo multicéntrico nacional realizado entre septiembre de 2015 y septiembre de 2016 en 37 hospitales con inclusión de pacientes menores de 16 años diagnosticados de IOA, confirmada mediante aislamiento microbiológico, o probable: artritis séptica (AS) con >40.000 leucocitos en líquido sinovial u osteomielitis (OM)/osteoartritis (OA)/espondilodiscitis (ED) con prueba de imagen compatible. Los resultados se compararon con los obtenidos en el estudio retrospectivo realizado entre 2008 y 2012. Resultados: Se incluyeron 255 casos: 131 OM, 79 AS, 30 OA y 15 ED. Respecto a las pruebas complementarias que el consenso consideró de obligada realización, la radiografía se llevó a cabo en el 87,8% de los casos, el hemocultivo en el 91,6% y el cultivo de líquido sinovial en el 99% de AS. Se realizó RM en el 71% de las OM. La elección del tratamiento antibiótico intravenoso empírico se adecuó a las recomendaciones en el 65,1% de los casos, y en el 62,3% para el tratamiento oral. Se llevó a cabo cirugía en el 36,8% de las AS (85,7% artrotomía), con un descenso significativo respecto al estudio retrospectivo (P = ,014). Solo el 58,5% de casos se ajustaron a las recomendaciones de duración del tratamiento; sin embargo, se comprobó una menor duración del tratamiento intravenoso. Conclusiones: En general, el grado de adecuación a las recomendaciones que marcaron el grupo de expertos es bueno para las pruebas complementarias y aceptable respecto a la elección del tratamiento antibiótico, aun detectándose casi un 40% de inadecuación. Se ha conseguido un descenso de la estancia hospitalaria.

Resumen: Introducción: En 2014 se publicó el Documento de Consenso desarrollado por SEIP-SERPE-SEOP para el diagnóstico y el tratamiento de las infecciones osteoarticulares (IOA). En 2015 se constituyó RIOPed como red nacional multidisciplinar para la investigación en IOA. El objetivo del estudio ha sido valorar el grado de adecuación a las recomendaciones establecidas en el consenso durante un año de seguimiento. Material y métodos: Estudio prospectivo multicéntrico nacional realizado entre septiembre de 2015 y septiembre de 2016 en 37 hospitales con inclusión de pacientes menores de 16 años diagnosticados de IOA, confirmada mediante aislamiento microbiológico, o probable: artritis séptica (AS) con > 40.000 leucocitos en líquido sinovial u osteomielitis (OM)/osteoartritis (OA)/espondilodiscitis (ED) con prueba de imagen compatible. Los resultados se compararon con los obtenidos en el estudio retrospectivo realizado entre 2008 y 2012. Resultados: Se incluyeron 255 casos: 131 OM, 79 AS, 30 OA y 15 ED. Respecto a las pruebas complementarias que el consenso consideró de obligada realización, la radiografía se llevó a cabo en el 87,8% de los casos, el hemocultivo en el 91,6% y el cultivo de líquido sinovial en el 99% de AS. Se realizó RM en el 71% de las OM. La elección del tratamiento antibiótico intravenoso empírico se adecuó a las recomendaciones en el 65,1% de los casos, y en el 62,3% para el tratamiento oral. Se llevó a cabo cirugía en el 36,8% de las AS (85,7% artrotomía), con un descenso significativo respecto al estudio retrospectivo (p = 0,014). Solo el 58,5% de casos se ajustaron a las recomendaciones de duración del tratamiento; sin embargo, se comprobó una menor duración del tratamiento intravenoso. Conclusiones: En general, el grado de adecuación a las recomendaciones que marcaron el grupo de expertos es bueno para las pruebas complementarias y aceptable respecto a la elección del tratamiento antibiótico, aun detectándose casi un 40% de inadecuación. Se ha conseguido un descenso de la estancia hospitalaria. Abstract: Introduction: In 2014 the Consensus Document produced by the Spanish Paediatric Societies (SEIP-SERPE-SEOP) was published to help in the diagnosis and treatment of osteoarticular infections (OAI). In 2015 the RIOPed was considered as a multidisciplinary national network for the investigation into OAI. The aim of this study was to assess the level of adaption to the recommendations established in the Consensus during one year of follow-up. Material and methods: A prospective, national multicentre study was carried out in 37 hospitals between September 2015 and September 2016. The study included patients > 16 years-old with a diagnosis of OAI, confirmed by microbiological isolation, or probable: septic arthritis (SA) with > 40,000 white cells in synovial fluid, or osteomyelitis (OM)/spondylodiscitis (SD) with a compatible imaging test. The results were compared with those obtained in a retrospective study conducted between 2008 and 2012. Results: A total of 235 cases were included, of which 131 were OM, 79 SA, 30 OA, and 15 SD. As regards the complementary tests that the Consensus considered mandatory to perform, radiography was carried out on 87.8% of the cases, a blood culture on 91.6%, and culture of the synovial fluid in 99% of SA. A magnetic resonance (MR) was performed on 71% of the OM cases. The choice of intravenous empirical antibiotic treatment was adapted to the recommendations in 65.1% of cases, and in 62.3% for the oral treatment. Surgery was performed in 36.8% of SA cases (85.7% arthrotomy), with a significant decrease compared to the retrospective study (P = .014). Only 58.5% of cases followed the recommendations on the duration of the treatment; however, a lower duration of intravenous treatment was observed. Conclusions: In general, the level of adaptation to the recommendations that were set by the Expert Group, is good for the complementary tests, and acceptable as regards the choice of antibiotic treatment, although inadequate in almost 40% of cases. A decrease in hospital stay was achieved.

Objective: To identify factors associated with the higher proportion of fatty tissue and overweight/obesity observed in patients with juvenile idiopathic arthritis (JIA). Patients and methods: We performed a cross-sectional study of 80 JIA patients aged 4–15 years with 80 age- and sex-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry. The 27-joint Juvenile Arthritis Disease Activity score (JADAS27) was calculated. Two multivariate models were constructed to identify factors associated with overweight/obesity and fat mass index (FMI). Results: No differences were found between cases and controls in body mass index (BMI) or body composition. However, compared with controls, patients with a high inflammatory activity (JADAS27 &gt, 4.2 for oligoarticular JIA or &gt, 8.5 for polyarticular disease) had higher values for BMI (p = 0.006), total fat mass (p = 0.003), FMI (p = 0.001), and fat in the legs (p = 0.001), trunk (p = 0.001), and arms (p = 0.002). The factors associated with overweight/obesity in patients were the duration of therapy with biological drugs, measured in months (OR [95% CI] = 1.12 [1.02–1.04], p = 0.037), and physical activity (OR [95% CI] = 0.214 [0.07–0.68], p = 0.010), while the factors associated with FMI were age (β [95% CI] = 0.30 [0.17–1.41], p = 0.014), JADAS27 (β [95% CI] = 0.45 [0.16–1.08], p = 0.009), and physical activity (β [95% CI] = −0.22 [−5.76 to 0.29], p = 0.031). Conclusion: Our study revealed no differences between JIA patients with well-controlled disease and low disability and the healthy population in BMI or body composition. Furthermore, the association observed between inflammatory activity and adiposity could be responsible for poorer clinical course.

INTRODUCCIÓN: El exantema mucocutáneo inducido por Mycoplasma (EMIM) es una entidad separada del síndrome de Stevens-Johnson(SSJ) y el eritema multiforme (EM), descrita principalmente en adolescentes y en la que predomina la afectación mucosa sobre la cutánea.OBJETIVO: Describir nuestra experiencia en pacientes pediátricos afectos de EMIM.MATERIALES Y MÉTODOS: Estudio descriptivo retrospectivo en menores de 14 años con EMIM entre 2015 - 2020.RESULTADOS: Se diagnosticaron 6 pacientes, agrupándose 5 entre enero-abril de 2019. En 5 casos hubo afectación de mucosa ocular, faríngea y urogenital. Las lesiones cutáneas vesículo-ampollosas fueron las predominantes. En todos se aisló M.pneumoniae. Debido a la afectación mucosa, 4 pacientes precisaron nutrición parenteral y 3 sondaje urinario. En 5 se prescribió tratamiento inmunomodulador con corticoides sistémico e inmunoglobulina intravenosa. La evolución fue favorable y la secuela más frecuente fue la xeroftalmia.CONCLUSIÓN: A pesar de la similitud clínica del EMIM con el SSJ y el EM, debemos sospecharlo en adolescentes con predominio de afectación mucosa. La evolución de nuestros pacientes fue favorable con tratamiento de soporte e inmunomodulador. Son necesarios estudios bien diseñados para establecer que pacientes se benefician de tratamiento con corticoides y/o inmunoglobulina.

Introduction: HIV infection was the main risk of suffering Pneumocystis jirovecii pneumonia (PJP). The clinical-epidemiological characteristics of PJP have currently changed, with there being few studies on this. Methods: A retrospective observational study was carried out on paediatric patients diagnosed with PJP over a 17 year period in a third level hospital in Spain. Results: A total of 23 patients were included, of whom 7/23 (47.8%) suffered a haematological disease, 5/23 (21.7%) a primary immunodeficiency, and 4/23 (17.4%) an HIV infection. Prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) was received by 11/23 (47.8%) patients. All were treated with TMP-SMX and 18/23 (78.3%) with systemic glucocorticoids. There were six (26.1%) deaths, of which one of them (16.7%) suffered an HIV infection. A higher mortality was seen in the non-HIV patients with greater leucocytosis, greater CO2 retention, and a higher heart rate at onset, differences not observed in HIV patients. No differences were found in mortality in relation to the predisposing factor, use of pTMP-SMX, or treatment with glucocorticoids. Conclusions: Paediatric patients with haematological cancers are currently the main risk group of developing PJP in this age group. No differences were found in mortality between patients with or without HIV infection as predisposing factor. The mortality among non-HIV patients was higher in those that had greater leucocytosis, greater CO2 retention, and increased heart rate at onset. A better prognosis was not seen in patients that received prophylaxis with TMP-SMX prior to the development of the PJP, or in those that received glucocorticoids as part of the treatment. Resumen: Introducción: La infección por VIH era el principal factor de riesgo para padecer neumonía por Pneumocystis jirovecii (NPJ). En la actualidad, las características clínico-epidemiológicas de la NPJ en niños han cambiado, existiendo pocos estudios en este sentido. Métodos: Realizamos un estudio observacional retrospectivo en pacientes pediátricos diagnosticados de NPJ durante 17 años en un hospital de tercer nivel en España. Resultados: Se recogieron 23 pacientes, de los que 11/23 (47,8%) padecían enfermedad hematológica, 5/23 (21,7%) inmunodeficiencia primaria y 4/23 (17,4%) infección por VIH. Recibía profilaxis con trimetoprim-sulfametoxazol (TMP-SMX) 11/23 pacientes (47,8%). Todos recibieron tratamiento con TMP-SMX y 18/23 (78,3%) glucocorticoides sistémicos. Fallecieron 6/23 pacientes (26,1%), de los que 1/6 (16.7%) padecía infección por VIH. En los pacientes no-VIH con mayor leucocitosis, mayor retención de CO2 y mayor frecuencia cardíaca al debut se evidenció mayor mortalidad, diferencias no objetivadas en pacientes VIH. No se encontraron diferencias en mortalidad en relación con el factor predisponente, empleo de pTMP-SMX ni tratamiento con glucocorticoides. Conclusiones: En la actualidad, los pacientes pediátricos con neoplasias hematológicas constituyen el principal grupo de riesgo de desarrollar NPJ en este grupo etario. No hemos encontrado diferencias de mortalidad entre pacientes con o sin infección por VIH como factor predisponente. Entre los pacientes no VIH la mortalidad fue mayor en aquellos que presentaron mayor leucocitosis, mayor retención de CO2 y mayor frecuencia cardíaca al debut. No se objetivó mejor pronóstico en pacientes que recibían profilaxis con TMP-SMX previamente al desarrollo de la NPJ ni en los que recibieron glucocorticoides sistémicos como parte del tratamiento.

Introduction: Height adjustment is currently recommended for Z-score bone mineral density (BMD) assessed by dual energy X-ray absorptiometry.At present there are no studies that evaluate the prevalence of low BMD in paediatric patients with juvenile idiopathic arthritis (JIA) in Spain following current recommendations. Objectives: To evaluate low BMD in JIA in paediatric patients with JIA in Spain following the latest recommendations, as well as to assess associated factors. Methods: Observational cross-sectional study of Spanish JIA patients from 5 to 16 years-old, followed-up in a Paediatric Rheumatology Unit between July 2014 and July 2015.Anthropometric, clinical and treatment data were recorded. Dual energy X-ray absorptiometry, and bone metabolism parameters were collected, and a completed diet and exercise questionnaire was obtained. Results: A total of 92 children participated. The population prevalence estimation of low BMD was less than 5% (95% CI).A significant positive correlation was found in the multiple linear regression analysis between the body mass index percentile (B: 0.021; P

Resumen: Introducción: Actualmente se recomienda ajustar por talla el Z-score densidad mineral ósea obtenido mediante absorciometría de rayos X de doble energía en pediatría. No hay estudios en nuestro medio que evalúen la prevalencia de baja densidad mineral ósea para la edad cronológica (BDMOec) en niños con artritis idiopática juvenil (AIJ) siguiendo estas recomendaciones. Objetivos: Estimar la prevalencia de BDMOec en niños con AIJ en nuestro medio y evaluar los factores implicados en su desarrollo. Métodos: Estudio observacional, transversal, en niños caucásicos de 5-16 años con AIJ, en seguimiento por una unidad de reumatología pediátrica entre julio de 2014-julio de 2015.Se recogieron datos antropométricos, clínicos y de tratamiento. Se realizaron absorciometría de rayos X de doble energía, estudio metabólico óseo y encuestas sobre dieta y ejercicio. Resultados: Participaron 92 niños. La estimación de la prevalencia poblacional de BDMOec fue inferior al 5% (IC 95%).En el análisis multivariante el percentil de índice de masa corporal (B: 0,021; p

Background Prevalence of secondary osteoporosis (SO) in children is an ongoing challenge, due to the rise in life expectancy of chronic diseases and the bone toxicity medication usage. Bisphosphonates (BF) has been stated as an alternative therapy, although studies targeted children are few. Objectives The goal was to establish the effectiveness and safety of bisphosphonate therapy in children with SO. Methods A retrospective study of BF treatment in children (≤16 years) with SO at a Pediatric Reumathology Unit from 2015 to 2018. Descriptive statistics were performed to examine anthropometric measurements, clinical features, diagnoses and treatment received. We measured bone mineral density by dual-energy x-ray absorptiometry and we expressed the results as adjusted for height-for-age Z-score (HAZ). We assessed the treatment outcome by the change of HAZ after a year treatment and the decreasing fractures rate per year. Afterwards we made a bivariate analysis to identify related factors with effectiveness and safety of bisphosphonates. Values of p Results In our study 12 patients were treated with BF, three of them with two different type. Table 1 shows the descriptive data. The HAZ and the fracture rate per year after a year of treatment were significantly lower [(-2,22±1,46) vs (-1,06±1,27); p=0,04, and (1 (0,5-2) vs 0 (0-0); p The change at HAZ and the before treatment fractures rate per year (r:0,57; p=0,07) were directly proportional. Also, the change at HAZ was inversely proportional to the before treatment Z-score (r: -0,53; p=0,09) and the BF starting age (r: -0,53; p: 0,09). The decrement of fractures rate per year showed a statistical significant relationship with BMI percentile (r:0,48; p=0,08), the treatment starting age (r:-0,537; p=0,05) and before treatment fractures rate per year (r:0,941; p Three patients experienced adverse effects (20%). Three related to zoledronate use: two of them showed flu-like syndrome after first infusion and the other asymptomatic hypocalcemia. In another patient the treatment with alendronate was ended due to gastrointestinal intolerance. There was not significant relationship between adverse effects and our study variables. Two patients died during the treatment due to their underlying disease complications. Conclusion BF are an effective medication for SO. The treatment outcome exhibits to be better with a good nutritional status, younger age and at more severe forms of the disease. Additionally, they are safe showing just minor adverse effects but often. References [1] Galindo Zavala R, Nunez Cuadros E, Diaz Cordoves-Rego G., Urda Cardona, AL. Advances in the treatment of secondary osteoporosis. An Pediatr (Barc). 2014; 81(6): 399.e1-399.e7. [2] Zemel BS, et al. Height adjustment in assessing dual energy x-ray absorptiometry measurements of bone mass and density in children. J Clin Endocrinol Metab.2010; 95(3): 1265–73. [3] Gordon CM, Leonard MB, Zemel BS. 2013pediatric position development conference: Executive summary and reflections. J Clin Densitom. 2014;17(2): 219–24. Disclosure of Interests Julia Ferrero Turrion: None declared, Rocio Galindo Zavala Grant/research support from: NOVARTIS, ABBVIE (ALWAYS AS SPEAKER), Speakers bureau: NOVARTIS, ABBVIE, Esmeralda Nunez Cuadros Grant/research support from: NOVARTIS, ABBVIE, ROCHE (ALWAYS AS SPEAKER), Speakers bureau: NOVARTIS, ABBVIE, ROCHE, Gisela Diaz-Cordobes Grant/research support from: ABBVIE, ROCHE (ALWAYS AS SPEAKER), Speakers bureau: ABBVIE, ROCHE, Laura Martin Pedraz: None declared, Antonio Urda Cardona Grant/research support from: PFIZER (ALWAYS AS SPEAKER), Speakers bureau: PFIZER

Background The incidence of non-bacterial osteitis (NBO), a rare autoinflammatory disease in childhood, has increased over the past few years. Early diagnosis and treatment, as well as an adequate follow-up, are necessary to prevent sequelae and complications. However, prognostic factors of the disease are unknown. Objectives To establish the prognostic factors of NBO. Methods A retrospective study of NBO, according to Jansson criteria, in children ( Results We reviewed 15 cases. Table shows the descriptive data. The likelihood of remission was found to be associated with the presence of X-ray findings apart from sclerosis/lysis, (80% vs 40%, p 0.07), a high white blood cell count (mm3) (11988.7 ± 3004.9 vs 8915.7 ± 3310.3, p 0.08) and ESR (mm) (58.3 ± 36.3 vs 26.8 ± 17.4, p 0.05) at diagnosis and a longer duration of disease (months) (5.7 ± 1.6 vs 3.1 ± 3.2, p 0.06). In addition, fewer relapses were found among patients with peroneal involvement [0 (0-0) vs 5 (1-6.7), p 0.05], a high white blood cell count at diagnosis (r -0.569, p 0.02) and those who were not treated with pamidronate [0 (0-5) vs 5 (1.2-6.7), p 0.07]. Finally, the lack of sequelae was related to the administration of pamidronate (100% vs 57.1%, p 0.07), younger age at diagnosis (years) (9.08 ± 1.4 vs 11 ± 2, p 0.07) and lesser CRP level at diagnosis (mg/L) [2.9 (2.9-2.9) vs 3.8 (2.9-3.8), p 0.005]. Conclusion Advanced cases of NBO, without radiological signs of sclerosis or lysis, were more likely to achieve remission. Elevation of acute phase reactants was related to a better response to treatment and a lower relapse rates, but with a greater probability of sequelae. As described in the literature, bisphosphonates achieve higher rates of clinical and radiological remission. In our study, they are also associated with a lower relapse rates and the lack of sequelae. The last is the main reason to be considered the first treatment choice in NBO. References [1] Schnabel A, Range U, Hahn G, Berner R, Hedrich CM. Treatment Response and Longterm Outcomes in Children with Chronic Nonbacterial Osteomyelitis. J Rheumatol. 2017; 44: 1058-1065 [2] Roderick MR, Sen ES, Ramanan AV. Chronic recurrent multifocal osteomyelitis in children and adults: current understanding and areas for development. Rheumatology. 2018; 57:41-48 [3] Zhao Y, Wu EY, Oliver MS, Cooper AM, Basiaga ML, Vora SS, et al. Consensus treatment plans for chronic nonbacterial osteomyelitis refractory to nonsteroidal anti-inflammatory drugs and/or with active spinal lesions. Arthritis Care Res (Hoboken). 2018; 70(8):1228-1237. Disclosure of Interests Nuria Heredia Torres: None declared, Esmeralda Nunez Cuadros Grant/research support from: NOVARTIS, ABBVIE, ROCHE (ALWAYS AS SPEAKER), Speakers bureau: NOVARTIS, ABBVIE, ROCHE, Rocio Galindo Zavala Grant/research support from: NOVARTIS, ABBVIE (ALWAYS AS SPEAKER), Speakers bureau: NOVARTIS, ABBVIE, Gisela Diaz-Cordobes Grant/research support from: ABBVIE, ROCHE (ALWAYS AS SPEAKER), Speakers bureau: ABBVIE, ROCHE, Laura Martin Pedraz: None declared, Antonio Urda Cardona Grant/research support from: PFIZER (ALWAYS AS SPEAKER), Speakers bureau: PFIZER

Height adjustment is currently recommended for Z-score bone mineral density (BMD) assessed by dual energy X-ray absorptiometry. At present there are no studies that evaluate the prevalence of low BMD in paediatric patients with Juvenile Idiopathic Arthritis (JIA) in Spain following current recommendations.To evaluate low BMD in JIA in paediatric patients with JIA in Spain following the latest recommendations, as well as to assess associated factors.Observational cross-sectional study of Spanish JIA patients from 5 to 16 years-old, followed-up in a Paediatric Rheumatology Unit between July 2014 and July 2015. Anthropometric, clinical and treatment data were recorded. Dual energy X-ray absorptiometry, and bone metabolism parameters were collected, and a completed diet and exercise questionnaire was obtained.A total of 92 children participated. The population prevalence estimation of low BMD was less than 5% (95% CI). A significant positive correlation was found in the multiple linear regression analysis between the body mass index percentile (B: 0.021; P.001) and lean mass index (B: 0.0002; P=.012), and BMD Z-score adjusted for height (Z-SAH). A significant negative correlation was found between fat mass index (B: -0.0001; P=.018) and serum type I collagen N-propeptide (B: -0,0006; P=.036) and Z-SAH.Low BMD prevalence in JIA patients in our population is low. An adequate nutritional status and the prevalence of lean over fat mass seem to promote the acquisition of bone mass. Those JIA patients with lower BMD could be subjected to an increase of bone turnover.