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FRI0477 Isolated Arthritis Revealing an Underlying Anti-Synthetase Syndrome: Results from a Multicentre International Study
  1. L. Cavagna1,
  2. M. Govoni2,
  3. F.J. Lopez Longo3,
  4. P. Airò4,
  5. R. Neri5,
  6. W.A. Sifuentes Giraldo6,
  7. F. Iannone7,
  8. L. Nuno8,
  9. C. Montecucco1,
  10. R. Caporali1,
  11. F. Furini2,
  12. V. Foschi2,
  13. F. Franceschini4,
  14. I. Cavazzana4,
  15. L. Quartuccio9,
  16. E. Bartoloni Bocci10,
  17. M. Giannini7,
  18. C. Sciré11,
  19. E. Fusaro12,
  20. S. Parisi12,
  21. G. Paolazzi13,
  22. G. Barausse13,
  23. C. Selmi14,
  24. J. Bachiller Corral6,
  25. E. Bravi15,
  26. G. Bajocchi16,
  27. R. Pellerito17,
  28. A. Russo17,
  29. S. Barsotti5,
  30. T. Pina Murcia18,
  31. S. Castaneda19,
  32. N. Ortego-Centeno20,
  33. A. Schwarting21,
  34. C. Specker22,
  35. L.A. Saketkoo23,
  36. J. Weinmann-Menke21,
  37. K. Triantafyllias24,
  38. M.-A. Gonzalez-Gay18
  39. on behalf of American and European Network of Antisynthetase Syndrome (AENEAS) collaborative group
  1. 1Division Of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia
  2. 2Clinic of Rheumatology, University of Ferrara, Ferrara, Italy
  3. 3Department of Rheumatology, Hospital Gregorio Marañόn, Madrid, Spain
  4. 4Rheumatology and Clinical Immunology Unit, University and AO Spedali Civili, Brescia
  5. 5Rheumatology Unit, University of Pisa, Pisa, Italy
  6. 6Rheumatology Department, Hospital Ramon y Cajal, Madrid, Spain
  7. 7Interdisciplinary Department of Medicine (DIM), Rheumatology Unit, University of Bari, Bari, Italy
  8. 8Rheumatology Department, Hospital Universitario La Paz, Madrid, Spain
  9. 9Department of Medical and Biological Sciences (DSMB), Clinic of Rheumatology, Santa Maria della Misericordia Hospital, Udine
  10. 10Rheumatology Unit, Department of Medicine, University of Perugia, Perugia
  11. 11Epidemiology Unit, Italian Society for Rheumatology, Milano
  12. 12Rheumatology Department, Città Della Salute e della Scienza, Torino
  13. 13Rheumatology Unit, Santa Chiara Hospital, Trento
  14. 14Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Milano
  15. 15Rheumatology Unit, Ospedale Guglielmo da Saliceto, Piacenza
  16. 16Rheumatology Department, Arcispedale S Maria Nuova. IRCCS, Reggio Emilia
  17. 17Rheumatology Unit, Ospedale Mauriziano, Torino, Italy
  18. 18Rheumatology Division, IDIVAL, Santander
  19. 19Rheumatology Department, Hospital Universitario de la Princesa, IIS Princesa, Madrid
  20. 20Systemic Autoimmune Diseases Unit, Hospital Clínico San Cecilio, Granada, Spain
  21. 21Department of Internal Medicine, Rheumatology and Clinical Immunology, Hospital Johannes-Gutenberg, Mainz
  22. 22Department of Rheumatology and Clinical ImmunologT, St. Josef University Hospital, Essen, Germany
  23. 23Pulmonary Diseases, Critical Care and Environmental Medicine, Tulane University, New Orleans, United States
  24. 24Rheumatology, Acura Hospital, Bad Kreuznach, Germany

Abstract

Background Articular involvement is reported to occur in up to 85% of patients with antisynthetase syndrome (ASSD) and it may be the only onset feature, although with frequencies and characteristics not still defined

Objectives To determine in a large international cohort of anti Jo-1 positive ASSD the prevalence of isolated arthritis at disease onset. To describe the clinical, serological and radiological characteristics and evolution of these patients

Methods We included all anti Jo-1 positive patients referring to participating centres and with an isolated arthritis at disease onset. The pattern of articular involvement, radiological and serological characteristics of patients were analysed. IgM-Rheumatoid factor (RF) was assessed by immunonephelometry; anti-cyclic citrullinated peptide antibodies (ACPA) by commercial second-generation ELISA kits; anti Jo-1 and anti-Ro positivity by commercially available ELISA kits

Results An isolated arthritis was the first manifestation in 54 (41 females, 13 males) out of the 225 patients included (167 females, 58 males), with a prevalence of 24%. Main characteristics of arthritis and overal results has been completely reported in table 1.

Conclusions We confirmed that an isolated polyarthritis is the first symptom of anti Jo-1 positive ASSD in up to a quarter of cases. Arthritis is mainly polyarticular and symmetrical, and the positivity for IgM RF or ACPA or both is not a rare finding, as well as the occurrence of marginal X-rays joint erosions. Anti-Ro positivity and RP occurrence may help clinician in the early identification of ASSD, even if the high rate of subsequent appearance of ILD and myositis clearly suggest that the screening for an underlying ASSD should be performed also in patients that may be undoubtedly diagnosed with RA.

References

  1. Cavagna L, et al. Characterization of anti Jo-1 positive antisynthetase syndrome: results from an international multicentre study. Arthritis Rheum 2014;11:S550.

  2. Lefèvre G, et al. Seronegative polyarthritis revealing antisynthetase syndrome: a multicentre study of 40 patients. Rheumatology (Oxford). 2014 Oct 27. pii:keu404. [Epub ahead of print]

Disclosure of Interest None declared

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