Background Autoimmune Scleritis is an extraarticular manifestations of severe rheumatoid arthritis, occur during the course of the disease and more rarely is the initial sign of the disease. This complication is usually a chronic disease that can be extremely painful and can lead to vision-threatening. There is a 1.2% prevalence of rheumatoid arthritis in a population of Peruvian Quechua ancestors and scleritis is not an uncommon manifestation.
Objectives Determine the risk of autoimmune scleritis in a population of Peruvian Quechua ancestors with rheumatoidarthritis.
Methods It was performed a cohort study in people with rheumatoid arthritis (RA) followed in therheumatology office at the Hospital III, Healthcare Network Juliaca, Puno, Perú; compared to those assessed in the ophthalmology office without history of autoimmune diseases,from January 2013 to December 2014. Statistical analysis was performed comparing proportions, analysis of man-hours anddetermining incidence rates.
Results Five cases were determined within 199 patients in the cohort of patients with RA, and seven cases were determined within the control group of 2592 patients: 3 patients withoutsystemic manifestations, one in relation to antibody anti-proteinase, 3 (ANCA-C), one withankylosing spondylitis and 4 classified as nonspecific oligoarthritis. The OR of scleritis in theAR group was 9.54; the incidence of scleritis was 8.42x1000 people. All patients were treated with topical and systemic corticosteroids. Two patients with RA had recurrence;one received cyclophosphamide 500 mg IV every 2 weeks presenting remission. Every case of scleritis and AR had anti-cyclic citrullinated peptide positive and only 4 patients hadpositive rheumatoid factor with high titles.
Conclusions Autoimmune scleritis is a severe complication of RA. This is the first study in a majority population of Quechua and mestizo ethnic groups; inhabitants of highlands. Causality is indisputable, associated with elevated antibodies; it is a further severe complication or form ofpresentation of RA; this justifies the creation of strategies for timely care.
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Acknowledgements To Eva, Natalia and Tatiana from Reumacenter, Juliaca, Perú.
Disclosure of Interest None declared
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