BackgroundPregnancy in rheumatic diseases is a process that requires careful handling, beginning with proper planning. Infertility and chronic use of teratogenic drugs are some common situations in these patients, giving them a high-risk obstetrics.ObjectivesTo established a protocol for planning and monitoring pregnancies in patients with rheumatic diseasesMethodsRetrospective review of a follow-up protocol for patients with rheumatic diseases and pregnancy wishes. This protocol includes: preconception consultation to asses fertility of the couple, as well as pregnancy couselling and establishment of a appropriate pharmacological treatment; after pregnancy period start, monthly consultations by a multidisciplinary team; and finally, a postpartum consultation after deliveryResultsA total of 51 patient with different rheumatic diseases were included: Sistemic Lupus Erythematosus (8 patients), Sjogren'S Syndrom (10 patients), Rheumatoid arthritis (13 patients), Psoriatic arthritis (5 patients), Behcet's disease (3 patients), Spondiloarthritis (2 patients), Familial Mediterranean Fever (2 patients), Conective mixed Tissues Disease (1 patient), Primary Antiphospholipi Syndrom (2 patient) an Hyper IgD Syndrome (1 patient). The results were: Infertility was detected in 8 couples and assisted reproductive techniques was requieres in 7 (6 IVF and 1 insemination). Safe Pharmacological treatments were used: sulfasalazine (4), hydroxychloroquine (13), azathioprine (2). Biological DMARDs in 3 patients (1 infliximab and Certlizumab in 2). Other treatments were: steroids (12) and intravenosus immunoglobulins for fetal heart block (2). All patients with thrombophilia have been treated with LMWH alone or plus aspirin. The course of pregnancy was:delivery at term (28), delivery pre-term (3)**, miscariages (3)*, pregnancy on course (7), neonatal death (1) and 8 patients are plannig the pregnancy. The abortions have occurred in 2 patients with lupus erythematosus and in 1 patient with rheumatoid arthritis. Postpartum care of newborns with mothers with positivity anti-Ro has objectified a neonatal transfer of Acs in 100% of cases;only 8 of them developed neonatal SLE.ConclusionsA satisfactory evolution of pregnancy was observed in 87% of our patients, a fact that supports our impression that this process should be approached in a multidisciplinary team. Infertility is a situation that should be considered and treated at an early stage in this patients, preferably before preconceptional period.Disclosure of InterestNone declared

BackgroundSystemic lupus erythematous (SLE) is an autoimmune disease characterised by deregulation of cytokine production. INF1A is a proinflamatory cytokine considered as a key molecule in the SLE etiopathogenesis, being responsible indirectly of IL10 upregulation. BLyS is involved in autoantibodies production and clinical activity in SLE, and its expression is regulated by other cytokines as IL10 and INF1A. IL2 is an anti-inflammatory cytokine in SLE, but its loss leads to the production of Th2 proinflammatory cytokines as IL4, IL5 and IL13.ObjectivesTo analyse the association among inflammatory cytokine levels and clinical activity, as well as to identify a cytokine profile related to disease activity in SLE.MethodsA cross-sectional, observational study of 142 patients diagnosed of SLESLICC 2012 criteria), and 35 healthy controls, was performed. A complete blood-test and an interview were carried out to collect their clinical data. We analysed inflammatory cytokines serum levels by colorimetric methods. Biostatistical analysis with R was performed.ResultsMean cytokine levels for the SLE patients and healthy controls are shown in the table 1.Abstract AB0058 – Table 1SLE patients (pg/mL)Mean (SD)Healthy controls (pg/mL)Mean (SD) IL24.34 (12.2)4,964,5IL458.65 (64.6)89,0570,18IL518 (5.71)7,338,59IL1012.29 (32.82)1,923,67IL1344.97 (273.78)42,8593,05IL213.18 (5.61)2,823,35INF1A15.69 (24.59)4,841,91BLyS2293.82 (6948.46)1181,15260,04The mean clinical activity measured by SLEDAI was 5.91±5.06, and we observed a statistically significant association between high levels of IL10 and high clinical activity (p=0.001).Statistical analysis indicates that complement consumption is associated with increased levels of IL10 (p=0.029), INF1A (p<0.001), IL4 (p=0.004), IL5 (p=0.009) and decreased levels of IL2 (p=0.045),; or anti-DNA positivity is associated with increased levels of INF1A (p=0.002) and decreased levels of IL2 (p=0.045), IL4 (p=0.034) and IL5 (p=0.007).Moreover, BLyS seems to have increased in patients with positive antiphospholipid antibodies and anti-DNA. IL10 is associated with ENAs positivity (p=0.022). In patients with other autoimmune disease associated with SLE, an increase of INF1A (p=0.008) and IL5 (p=0.044) is observed.SLE patients were categorised by normal, low or high level of the eight citokines. Despite the fact that no specific cytokine profile associated with clinical activity was observed, those patients with high SLEDAI score had increased levels of IL10 and INF1A and decreased levels of IL2 and IL21.ConclusionsOur SLE patients displayed mainly IL10, INF1A and BLyS increased, and IL2 decreased. Although IL10 seems to be the cytokine which best fits to clinical activity in SLE, altered levels of INF1A, IL2, IL4, and IL5 are associated with complement consumption or anti-DNA positivity.Disclosure of InterestNone declared

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BackgroundInterstitial lung diseases (ILD) it’s a frequent complication in connective tissue diseases (CTD) such as rheumatoid arthritis (RA) or systemic sclerosis (SS), but the lung is the only affected organ in the idiopathic pulmonary fibrosis (IPF). Nonspecific interstitial pneumonia (NSIP) is the more frequent form in SS while usual interstitial pneumonia (UIP) predominates in RA patients and in the IPF form. Some studies suggested that 18-FDG-PET/CT could help to detect zones of activity in lung tissue in IPF and this in turn could predict the disease progress, but results are inconclusive. Moreover, little is known about the value of 18-FDG PET uptake in ILD associated to RA or SS.ObjectivesThe purpose of this study is to evaluate the predictive value of 18 FDG-PET/CT scan images in functional pulmonary progression of ILD associated to RA or SS.MethodsWe conducted a 12 month prospective observational study on patients diagnosed with ILD associated to SS or RA between January 2015 and May 2017. ILD diagnosis was based on clinical assessment, pulmonary function tests (PFTs) and expert HRCT evaluation. We performed three visits: basal, 6 month and 12 month. On all visits a general exploration, forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO) were carried out. On basal and 6 month visit a 18-FDG-PET/TC was performed within a period of three months from the PFTs. Patients continued with their treatment (corticosteroids, DMARDs or immunosuppressants). The nuclear medicine physician identified the maximum and mean standardised uptake value (SUVmax and SUVmean) in the three areas with the most FDG uptake, and adenopathies uptake. PET/CT images were reviewed by 2 combined radiologist/nuclear medicine physicians in consensus.ResultsWe included 17 patients, 10 had UIP associated with RA and 7 NSIP related to SS. It appeared that RA patients had longer lung illness evolution and worse FVC than SS patients (table 1), in spite of not having found statistical differences. We detected significant statistical relation between the highest SUVmax and FVC (p=0.009) or DLCO progression (p=0.006) in SS patients, independently of the basal FVC and DLCO, and duration of lung illness in a multivariable linear mixed model. We didn’t find any relation between SUVmax and FVC or DLCO progression in RA patients.ConclusionsIn our cohort of patients with SS, 18 FDG PET/TAC can aid in predicting the progression of ILD associated disease, which does not occur in RA patients.Disclosure of InterestNone declared