The present study demonstrates a higher sensitivity of ultrasound with respect to physical examination in the detection of signs indicative of enthesopathy in SpA patients with an adequate interreader and intrareader reliability. Further study is needed about the prognostic value of the ultrasound findings for predicting clinical onset of entheseal involvement.

BackgroundDysphagia has been reported to occur in 10% to 73% of these patients and can be present at any time during the disease process (1).ObjectivesThe primary objective of the study was to evaluate the prevalence of dysphagia in a cohort of patients with idiopathic inflammatory myopathy (MII) and to evaluate factors associated with the presence of dysphagia. The secondary objective was to evaluate the factors associated with severe dysphagia.MethodsRetrospective, observational study, which included patients with a diagnosis of MII according to modified classification criteria of Bohan and Peter (1992-2018). Demographic data, clinical characteristics, laboratory data, autoantibodies, imaging studies, videodeglution, muscle biopsy and EMG were recorded.Severe dysphagia was considered: one in which oral feeding was contraindicated and/or which required nasogastric tube feeding (SNG) either by clinical evaluation or by videodeglution study. The rest of the patients with dysphagia who did not present a contraindication to oral intake during the course of the disease were considered mild/moderate dysphagia.Results94/110 patients were included, 76% female, mean age at diagnosis: 48 years (SD ± 14). Idiopathic dermatomyositis was the most frequent subtype of myopathy (64%). Dysphagia occurred in 53/94 patients (56.4%) and it was presented at the beginning of the disease in 31/94 (32%). Severe dysphagia was found in (22/94) 23%.When analyzing the clinical features of patients with myopathy and dysphagia, it was found that Idiopathic dermatomyositis was the most frequent MII in these patients (71%). Patients with dysphagia presented: proximal muscle weakness 90%, neck muscles weakness 47%, and respiratory muscle weakness 27%.Treatment received: 90/94 (97%) oral glucocorticoids, mean dose 48 mg of prednisone (Range 4 -100 mg.), pulses of Intravenous methylprednisolone was indicated in 25 patients (27.5%).The main steroid sparing agents used were: 72% methotrexate, followed by 33% azathioprine.Significant association was found between dysphagia and weakness of neck muscles, respiratory muscles, of glucocorticoid pulses, gamma globulin and mortality (data not shown). In the Logistic Regression analysis, no variable was independently associated with the presence of dysphagia.When analyzing the relationship of severe dysphagia and factors associated, a significant association was found with the requirement of mechanical ventilation, hospitalization in an intensive care unit, serious infections, neoplasia and mortality (Table 1). In the multivariate analysis: no associated factors were found independently.Table 1Variable severe dysphagia (present) n=22 (%) severe dysphagia (absent) n=72 (%) p ORIC Weak neck muscles 15 (68%) 18 (25%) <0.001 8.86 2.75-8.86 Weakness of respiratory muscles 10 (45%) 6 (8%) <0.001 9.5 2.8-32 pulses of corticosteroids 17 (77%) 8 (11%) <0.001 25 7.5-89.5 intravenous gammaglobulin 10 (45%) 7 (9%) <0.001 7.73 2.46-24 intensive care unit 8 (36%) 8 (11%) <0.001 4.57 1.46-14.2...

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Background Cigarette smoking is a well-established environmental risk factor related to the development of multiple autoimmune diseases, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), multiple sclerosis, Graves’ hyperthyroidism, and primary biliary cirrhosis, among others. Furthermore, smoking habit has been associated with several autoimmune phenomenons. Objectives The aim of the study was to evaluate the relationship between smoking habit, presence of auto antibodies and rheumatoid arthritis diagnosis in an early arthritis cohort. Methods Consecutive outpatients attending to the Early Arthritis Clinic were evaluated and included in the study at first visit if they had at least 1 or more swollen joints and less than two years of duration. Social, demographics, familiar, hereditary, and clinical data were recollected. DAS28, HAQ, RADAI, RAQoL, general biochemistry, RF, anti CCP2 by ELISA and others immunologic studies that the physician considered of importance were determined. At first visit and every year X-rays of hands and feet were performed and working characteristics and pharmaco-economic data were recollected. Specific information on smoking included smoking status (current smokers or ex-smokers/non smokers), smoking duration and average numbers of cigarettes smoked per day measured by number of pack years = (number of cigarettes smoked per day × number of years smoked)/20. Statistical Analysis: data from the base were captured by SPSS v 15.0 performing an exploratory analysis of all variables. Categorical variables were compared by Chi2 test o Fisher. P values <0.05 were considered statistically significant. Results 155 patients were evaluated from July 2007 until June 2011. 125 (80,6%) were women and 30 (19,35%) men. 72 patients fulfilled criteria for RA (ACR 87 and ACR/EULAR 2010), 15 Undifferentiated Arthritis, 68 others diagnosis. The mean time between the onset of the symptoms and the first visit to the Early Arthritis Clinic was 7,68±6,19 months. Fifty patients presented current or ex smoking habit (32%). 21/72 RA patients were current smokers (29%) (p=0.35). 49 patients were AntiCCP +, 18 of them were current smokers (36%) (p=0.31). 27 patients were ANA +, 8 of them were current smokers (p=0.85) and 64 patients were RF +, 20 were current smokers (p=0.21). Smokers (n=50)Non-smokers (n=105)OR CI 95%p AntiCCP+ (n=49)18160,672-3,4530,311 RF+ (n=64)20440,303-1,3060,213 ANA+ (n=27)8190,336-2,4720,856 RA (n=72)21510,369-1,4320,356 Conclusions We found no influence of smoking in the occurrence of RA or in the production of anti-CCP, RF or ANA antibodies in our cohort of Argentinian patients with early arthritis References Effects of Smoking on Disease Activity and Radiographic Progression in Early Rheumatoid Arthritis. Ruiz-Esquide V, Gόmez-Puerta JA, et al. J Rheumatol December 2011 38(12):2536-2539. Tobacco smoking and autoimmune rheumatic diseases. Harel-Meir M, Sherer Y, Shoenfeld Y. Nature Reviews Rheumatology 3, 707-715 (December 2007). Does Cigarette Smoking Influe...

Objectives: To determine the frequency of autoimmune diseases (AID) in Rheumatoid Arthritis (RA) patients and to compare this frequency between patients with and without RA or other rheumatologic AID. Methods: Multicenter, observational, analytical, retrospective study. Consecutive patients with diagnosis of RA (ACR/EULAR 2010) were included. Patients with initial diagnosis of primary ostearthritis (OA) were used as control group. Results: A total of 1549 patients were included: 831 RA (84% women, mean age 55.2 [±13.6]) and 718 OA (82% women, mean age 67 ([± 11.1]). The frequency of AID in the RA group was 22% (n=183). RA patients showed higher frequency of rheumatologic AID (9.4 vs 3.3%, p< 0.001), and lower frequency of non-rheumatologic AID than OA patients (15.3 vs 20.5%, p= 0.007). The most prevalent rheumatic AID was Sjögren’s Syndrome, which was more fre-quent in the AR group (87.2 vs 29.2%, p<0.001). The frequency of rheumatologic AID in RA patients was higher in those with erosive RA (11 vs 6.8%, p=0.048). Conclusion: The frequency of AID in RA patients was 22%. Rheumatologic AID were more frequent in RA patients, whereas non-rheumatologic AID prevailed in OA patients.