for the Garches COVID-19 Collaborative Group RECORDS Collaborators and Exhalomics Ò Collaborators a Hôpital Foch, Exhalomics Ò , D epartement des maladies des voies respiratoires, Suresnes, France (S.

Aim: A multicentre retrospective study was undertaken to examine patients with interstitial lung disease (ILD) with the initial clinical manifestation of an anti-synthetase syndrome (anti-Jo-1 antibodies), and to analyse the characteristics and long-term outcome of these patients according to their clinical presentation (acute or gradual onset), treatment and adverse events related to treatment. Methods: 32 patients, 15 (47%) presenting with acute onset and associated respiratory insufficiency (group A) and 17 (53%) with gradual onset (group G) were examined. Myositis was diagnosed at admission in only 31% of cases and was observed during follow-up in 56% of cases, but the prevalence did not differ between the two groups. Results: Fever and radiological patterns including diffuse patchy ground-glass opacities, basal irregular lines and consolidation on high-resolution CT scan were more frequent in group A than in group G. More patients in group G had neutrophils in the bronchoalveolar lavage fluid and autoantibodies other than anti-Jo-1 (rheumatoid factor, anti SSa/SSb) than in group A. The percentage of patients in whom the ILD improved at 3 months was significantly higher in group A than in group G (13/15 vs 9/17; p = 0.006). In contrast, after 12 months, most patients with ILD progression were in group A and were treated with corticosteroids alone. A combination of corticosteroids and an immunosuppressive drug was required in most cases (84%) at the end of the follow-up period. Severe adverse effects of treatment were observed and varicella zoster virus infection was frequent. Conclusions: Early testing for anti-synthetase antibodies, particularly anti-Jo-1, and creatine kinase determination are useful procedures in patients presenting with ILD.

been described in EGFR-TKIs treated patients, especially with Staphylococcus aureus nasal carriage or extensive midface involvement. 5 Inhibition of EGFR signaling on epidermal and adnexal epithelium may lead to skin barrier impairment with increased bacterial carriage. Then, it is still unclear if EGFR-TKIs-induced skin lesions increase P. acnes colonization or if P. acnes is directly involved in skin toxicity as it is in acnea vulgaris. Topical and systemic antibiotics have been used to treat these skin lesions. 2 Interestingly, tetracycline is used mostly for its immunomodulatory properties, but its antibiotic activity against P. acnes could prevent the risk of invasive infections. Moreover, prophylactic treatment should be considered before piercing an altered skin to decrease bacterial carriage and therefore, the risk of bacterial seeding.We describe the first case of P. acnes pleural empyema associated with EGFR-TKIs. Increasing use of these molecules should warn clinicians of this rare but potentially lethal complication especially with thoracocenteses.

Excessive absolute numbers and percentages of alveolar lymphocytes were observed in 18 and 16 patients, respectively. Most alveolar lymphocytes were CD8+ cells.

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