BackgroundBehcet’s disease (BD) is characterized by oral, genital, and gastrointestinal manifestations. The pathergy test is used as a diagnostic tool, but this is not specific to BD, since it can be found in other diseases and can equally be negative even having the disease.Another characteristic of BD is the vascular compromise, predominantly venous. In a study, the measurement of the thickness of the common femoral vein (CVF) proved to be a diagnostic test with sensitivity and specificity greater than 80% for the cut-off value of 0.5 mm.ObjectivesTo evaluate the diagnostic performance of the thickness of the posterior wall of the common femoral vein, measured by Doppler ultrasound for the diagnosis of Behcet’s disease.MethodsA multicenter pilot study was carried out to evaluate a diagnostic test. Data were collected by reviewing medical records collected from patients who met the 2014 International Criteria for Behcet’s Disease (ICBD), and healthy controls. Venous Doppler ultrasound of the lower limbs was performed in both groups using an ultrasound evaluation protocol, considering posterior wall thickness of the CFV ≥ 0.5 mm as positive.Results19 patients with EB and 19 healthy controls were included. The mean age of patients with DB was 47 (SD 12.6), and the median age of healthy patients was 41 years (IQR 36.5-48.5). 57.89% were mestizo in the BD group and 68.42% in the control group.The median delay in diagnosis was 19 months (IQR 11-36). The presence of HLA B51 was 63.15% and the positive pathergy test was found in 31.57%. At the time of the study, 42.10% had disease activity and a mean of 8.8 years of disease. (Table 1)The ultrasound was positive in 89.4% of patients with BD and 10.5% in the healthy group, observing a sensitivity of 94.1% and a specificity of 94.7%, with an area under the curve 0.89 (p < 0.0001), PPV 94.1% and NPV 94.7%. (Fig. 1)We observe a post-test probability of 0.059. The test presents LR + 17.8 (95%CI 2.5-127) and LR - 0.06 (95%CI 0.008-0.4)ConclusionThe diagnosis of Behcet’s disease is difficult because it is based mainly on clinical manifestations, so this ultrasound test has a good capacity to be used as part of the diagnosis in patients with clinical suspicion, since it has a good sensitivity and specificity profile, low cost and simplicity.References[1]Jennette JC, Falk RJ, Bacon PA et al. 2012 revised International Chapel Hill Consensus conference nomenclature of vasculitides. Arthritis Rheum 2013;65: 1–11.[2]Calamia KT, Schirmer M, Melikoglu M. Major vessel involvement in Bechet’s disease: an update. Curr Opin Rheumatol 2011; 23:24–31.[3]Alibaz-Oner F, Ergelen R, Yildiz Y, Aldag M, Yazici A, Cefle A, Koç E, Artim Esen B, Mumcu G, Ergun T, Direskeneli H. Femoral vein wall thickness measurement: A new diagnostic tool for Behçet’s disease. Rheumatology (Oxford). 2021 Jan 5;60(1):288-296. doi: 10.1093/rheumatology/keaa264. PMID: 32756998.[4]Tezcan D, Özer H, Gülcemal S, Hakbilen S, Durmaz MS, Batur A, Yilmaz S. Diagnostic Performance of Lower Extremity Venous Wall Thickness and Laboratory Findings in the Diagnosis of the Behçet Disease. J Clin Rheumatol. 2022 Mar 1;28(2):e521-e527. doi: 10.1097/RHU.0000000000001788. PMID: 34538847.Table 1Demographic, clinical and treatment characteristics.Fig. 1ROC CurveAcknowledgements:NIL.Disclosure of InterestsNone Declared.

BackgroundInterstitial lung disease (ILD) and pulmonary arterial hypertension (PHT) account for 60% of deaths related to scleroderma (SSc) [1]. The Red Cell Distribution Width (RDW) is a biomarker that has been used as a marker of poor prognosis in various pathologies[2-9]. In SSc, the RDW has been found to be elevated in PHT and has been proposed as a predictor of cardiorespiratory compromise[10-11].ObjectivesTo evaluate the association between the increase in RDW and the presence of ILD in patients with SSc.MethodsObservational, retrospective, multicenter, cross-sectional study of patients with SSc (ACR/ EULAR 2013) between 1/1/2011 to 8/31/2021. Other concomitant autoimmune diseases, malignancy, active infections, anemia, recent transfusions, cardiovascular, renal, or hepatic disease were excluded. The diagnosis of ILD was made by high-resolution computed tomography (HRCT) and the extension evaluated by Goh criteria¹². A review of medical records was performed, collecting relevant clinical and demographic characteristics.ResultsSeventy-five patients were included, with a mean age of 59.4 years (SD 14.1, 95% CI 56-63), 67 (89%) were women. A median of 8 years of disease evolution was observed (IQR 8). ILD was observed in 50 (66,6%) patients while 25 (33.3%) did not. According to Leroy’s classification, limited SSc (lcSSc) was observed in 50 patients (66,6%) and diffuse SSc (dSSc) in 24 (33,3%); the last classification was significantly associated with the presence of ILD, as was as MRSS (Modified Rodnan Skin Thickness Score)> 14, digital ulcers, and positive ATA (DNA topoisomerase I), unlike ACA (anticentromere antibodies) (Table 1).The most frequent HRCT pattern was NSIP (Nonspecific interstitial pneumonia) in lcSSc (66.6%). An association was found between dSSc and fibrotic patterns (fNSIP and UIP). OR 6, 95% CI 1.6-21 (p 0.009).The extension of the disease was measured in 44 patients (6 missing data), being limited in 25 (57%) and extensive in 19 (43%). The extensive form was correlated with a higher RDW mean (p < 0.0001).The MRSS was measured in 70 patients, being less than 14 in 63 (90%). 100% of the patients with mRSS > 14 had a high RDW (p 0.01).Increased RDW was evidenced in the group with ILD, with a statistically significant difference (OR 6.06 95%CI 2-17 p 0.001).The median RDW in the groups with isolated ILD and ILD plus PHT was significantly higher than in patients without lung disease (p < 0.001). We found no significant difference between the ILD and ILD plus PHT groups (p 0.350) (Figure 1).Figure 1.ConclusionWe have been able to show that there is a significant relationship between the increase in RDW and the presence of ILD in patients with SSc; this association was more significant for the extensive forms of the disease as well as fibrotic patterns.These findings are relevant as the RDW is an easily accessible parameter that could be used in the follow-up of patients with SSc, and an elevation not explained by other causes of the RDW could be an alarming marker to search more exhaustively for the presence of cardiorespiratory compromise.The limitations of the study are those of any retrospective study, the presence of missing data in addition to the limited number of patients. It is necessary to continue studies with a larger number of patients to grant robustness to the results.References[1]Muangchan, et al. The Journal of Rheumatology 2013; 40; 9.[2]Cottin and Brown. Respiratory Research (2019) 20:13[3]L. A. Allen et al. Journal of Cardiac Failure, vol. 16, no. 3, pp. 230–238, 2010.[4]S. Dabbah et al. American Journal of Cardiology, vol. 105, no. 3, pp. 312–317, 2010.[5]Abul et al. Chronic Respiratory Disease 2014, Vol. 11(2) 73–81[6]Smukowska-Gorynia A, et al. Heart, Lung and Circulation (2017).[7]Hampole et al. Am J Cardiol 2009;104:868–872[8]Thayer, T. E. et al. Annals of the American Thoracic Society. doi:10.1513/annalsats.201809-594oc.[9]Jie Yang et al. Canadian Respiratory Journal Volume 2019, Article ID 3853454.[10]Farkas N et al (2014) Rheumatology (Oxford) 53:1439–1445.[11]Forhecz Z et al. Am Heart J 2009;158:659-66.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

BackgroundDuring the last 2 years, the SAR COV2 pandemic has impacted the lifestyle, health care, physical and psychological health status of people with rheumatic diseases. In the REUMAVID study, almost half of the respondents stated that their state of health had worsened during the pandemic[1]. It’s known that aspects such as fear, job loss, social isolation, uncertainty about their treatments, worsening of symptoms due to the interruption of treatment and hospital visits, increased his fatigue and pain[2].Treatment adherence estimates in patients with RA are usually low (Between 30 and 80%)[3]. Adherence lack has been associated with worsening symptoms and increased disability[4].ObjectivesThe aim of this work is to evaluate SARS COV2 pandemic impact on the adherence perception in a cohort of patients with RA and their clinical associations.MethodsDescriptive cross-sectional study; included patients ≥18 years old with RA (ACR/EULAR 2010 criteria), between June 1 and July 31, 2022 who gave their written consent to perform the questionnaire.Data sociodemographic, socioeconomic level (Graffar modified), clinical, laboratory, treatments, previous COVID-19 infection and vaccination status were consigned. Activity was evaluated by DAS28-PCR and functional ability with HAQ-II.Questions about the perception of the impact of the pandemic on adherence, follow-up, health status deterioration or fear of continuing treatment were included. They were measured by a visual analogue scale, with 0 being no impact and 10 being the maximum. These answers were compared with adherence measured by the Compliance Questionnaire for Rheumatology (CQR5).ResultsSixty nine outpatients with RA were included. 45 patients (65%) did not perceive adherence changes during the pandemic while 24 (35%) perceive some degree of adherence disturbances. Sociodemographic characteristics are detailed in Table 1.Having an independent laboral status and the modification or suspension of work activity was statistically associated with the perception of impaired adherence (p=0.04 and 0.01 respectively).Patients with a perception of impaired adherence had significantly higher means in the VAS of affected follow-up, deterioration in their health status, and fear of infection (p= <0.001, <0.001 and 0.04 respectively). DAS28-PCR, HAQ-II, ERS and CRP were also significantly higher in this group (p= 0.002, 0.005, 0.01 and 0.04 respectively).No association was found between the perception of adherence disturbance and adherence measured by CQR5 (p= 0.20).ConclusionThe SARS COV2 pandemic has a great impact on adherence, rheumatological follow-up and quality of life of patients with RA.Although the perception of adherence disturbance during the pandemic period is a subjective parameter, we found a significant association between this perception and higher rates of suspension or modification of work activity, greater disease activity, functional impairment, and higher acute phase reactants.Studies with a larger number of patients are needed to corroborate these findings.References[1]Garrido-Cumbrera M, Marzo-Ortega H, Christen L, et al. Assessment of impact of the COVID-19 pandemic from the perspective of patients with rheumatic and musculoskeletal diseases in Europe: results from the REUMAVID study (phase 1) RMD Open 2021;7:e001546.[2]Pope JE. What does the COVID-19 pandemic mean for rheumatology patients? Curr Treatment Opt Rheumatol. 2020;30:1-4.[3]Van den Bemt BJF, van Lankveld GJMW. How can we improve adherence to therapy by patients with rheumatoid arthritis? Nat Clin Pract Rheumatol 2007;3:68.[4]Curtis JR, Bykerk VP, Aassi M, Schiff M. Adherence and Persistence with Methotrexate in Rheumatoid Arthritis: A Systematic Review. J Rheumatol. 2016 Nov;43(11):1997-2009.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

BackgroundInterstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) account for 60% of deaths related to scleroderma (SSc). The erythrocyte distribution width (RDW) has been used as a marker of poor prognosis in different pathologies. In SSc, RDW has been found to be elevated in PAH and has been proposed as a predictor of cardiorespiratory compromise.ObjectivesThe aim of this study is to evaluate the association between increased RDW and the presence of EPI in patients with SSc.MethodsThis is a multicenter, retrospective, cross-sectional study of patients diagnosed with SSc (ACR/EULAR 2013) from January 2011 to August 2021. Other concomitant autoimmune diseases, malignancy, active infections, iron-deficiency or pernicious anaemia and transfused patients were excluded. The diagnosis of PID was made by high-resolution computed tomography (HR-CT) and the extension evaluated by Goh criteria. A review of medical records was conducted, collecting clinical and demographic characteristics, interstitial pattern by HR-CT, assessed, acute phase reactants, capillaroscopy, functional respiratory tests (PFT) and echocardiographic resolution. Patients diagnosed with PAH by right heart catheterization were not excluded in this study but recorded.ResultsSeventy-five patients were included, with a mean age of 59.4 (SD 14.1 CI95% 56-6), from which 67 (89%) were women. A median of 8 years of disease evolution was observed RIC 8). Limited SS was observed in 50 (66%) and diffuse SS in 24 (32%). EPI was observed in 50 (66%) of which NSIP 25 (33%), NSIP-f 15 (20%) and UIP 10 (13%). The extension of the disease was limited in 25 (33%) and extensive in 19 (25%). Capillaroscopic findings were normal in 2 (3.4%), nonspecific in 1 (1.7%), early SD in 9 (15.3%), active SD in 22 (37.3%), and late SD in 25 (42.4%); in sixteen patients there was no capillaroscopy.We observed an increase in RDW in the EPI group with a statistically significant difference OR 6.06 CI95% 2-17 (p 0.001).The median RDW is higher in patients with ILD and PAH than in healthy people (p<0.0001).We found a low negative correlation between RDW / FVC r (63) -.25 p 0.042 and RDW / FEV1 r (63) .30 p 0.015.ConclusionIn the present study we have been able to evidence that there is a statistically significant relationship between the percentage of RDW and the presence of PID. When analysing the association between patients without pulmonary compromise, ILD and PAH and the percentage of RDW, we were able to find a statistically significant difference between the three groups. It is necessary to continue with studies with a larger number of patients to grant robustness to the results.References[1]Muangchan, et al: 15% rule in SSc. The Journal of Rheumatology 2013; 40; 9; doi:10.3899/jrheum.121380.[2]Cottin and Brown. Interstitial lung disease associated with systemic sclerosis (Ssc-ILD) Respiratory Research (2019) 20:13[3]Thayer, T. E. et al. Unbiased Phenome-wide Association Studies of Red Cell Distribution Width Identifies Key Associations with Pulmonary Hypertension. Annals of the American Thoracic Society. doi:10.1513/annalsats.201809-594oc.[4]Zhao J,Mo H, Guo X,Wang Q, Xu D, Hou Y, Tian Z, Liu Y,Wang H, Lai J, Li M, ZengX (2018) Red blood cell distribution width as a related factor of pulmonary arterial hypertension in patients with systemic sclerosis. Clin Rheumatol 37:979–985.[5]Goh NSL, Desai SR, Veeraraghavan S, et al. Interstitial Lung Disease in Systemic Sclerosis: A Simple Staging System. American Journal of Respiratory and Critical Care Medicine. 2008. June;177(11):1248–54.[6]Hax V, Bredemeier M, Didonet Moro AL, et al. Clinical algorithms for the diagnosis and prognosis of interstitial lung disease in systemic sclerosis. Seminars in Arthritis and Rheumatism. 2017. October;47(2):228–34.[7]Peralta S. Guías Argentinas De Consenso En Diagnóstico Y Tratamiento De La Hipertensión Pulmonar. Sociedad Argentina de Cardiología. Área de Consensos y Normas. Vol 85 Suplemento 3. Octubre 2017.AcknowledgementsParticipating centersDisclosure of InterestsNone declared