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BackgroundStudies in Autoimmune Inflammatory Myositis (AIM) have shown that certain antibodies have a role in the diagnosis and prognosis of patients with myositis. This ongoing study presents the preliminary data of 48 patients of Indian AIM.ObjectivesTo study the prevalence of Myositis specific and Myositis Associated antibodies (MSA and MAA respectively) in Indian patients with AIM and to correlate these antibodies with clinical features.MethodsAll consecutive patients with Inflammatory myositis (satisfying the Bohan and Peter criteria, 1975 attending the Rheumatology and Clinical Immunology department of Medanta hospital from November 2016 to October 2017 were included prospectively and divided into groups as Dermatomyositis (DM), Polymyositis (PM), CTD associated myositis (CTD-M), Cancer associated myositis (CAM) and Juvenile Myositis (JM). Their clinical data and sera were collected after obtaining informed consent. Sera was analysed for IgG antibodies against Jo-1, PL-7, PL-12, EJ, SRP, Mi-2, MDA-5, TIF1γ, SAE1, SAE2, NXP2 and SSA/R052kD using the microELISA technique (BlueDriver Dot Myositis12 SAE IgG kit). Their ENA was also recorded (Blue DriverQuantrix-ANA25 Screen IgG kit d-tek). Results were read by the BlueScan scanner and value ≥10 were considered positive. The study was approved by the Ethics committee of Medanta hospital.ResultsThere were 48 patients in the cohort (M:F=12:36) with the mean age of 41.3 years and a median disease duration of 30 months. Nineteen of them were DM, 19 were PM, 5 were CTD-M, 2 were CAM and 3 were JM. 58.3% were ANA positive and MSA were positive in 37.5% of the cohort, MSA being mutually exclusive. Antibodies against Mi-2 were present in 6 patients (12.5%), Jo-1 antibodies in 5 (10.4%), 2 (4.1%) patients each had PL-7 and SRP antibodies. One patient (2%) each had MDA-5, NXP2 and TIf1γ antibodies. MAAs were seen in 39.5% of the cohort with antibodies against Ro, RNP and PM- Scl seen in 16 (33.3%), 2 (4.1%) and 1 (2%) respectively. Mi-2 antibodies were seen only in DM and JM group. The lone patient who had MDA-5 antibody had amyopathic DM. Malignancy screening was negative in NXP2 and TIF1γ antibody positive patients.ConclusionsMSA were present in almost 40% of the cohort. Mi-2 antibodies were associated with rash and none had ILD whereas Jo-1 antibodies were associated with mechanic hands, arthritis and ILD. With further recruitment of patients in this ongoing study, we hope to get more robust data in future.Disclosure of InterestNone declaredAbstract SAT0504 – Table 1Myositis Antibody distribution according to clinical features.Proximal muscle weakness (%) (n=46)Pharyngeal muscle weakness (%) (n=17)Rash (%) (n=28)Mechanic hands (%) (n=5)Raynaud’s (%) (n=11)Digital Ulcer (%) (n=2)Arthritis (%) (n=13)ILD (%) (n=11)Total (n=48) Myositis Specific AntibodiesMI-26 (13)2 (11.7)6 (21.4)01 (9)01 (7.6)06 (12.5)JO-14 (8.6)1 (5.8)3 (10.7)3 (60)2 (18.1)03 (23)4 (36.3)5 (10.4)NON JO-I ARS (PL-7)1 (2.1)02 (7.1)02 (18.1)001 (9)2 (4.1)SRP2 (4.3)0000001 (9)2 (4.1)MDA-5001 (3.5)1 (20)1 (9)...

Introduction: Diagnosis and management of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a challenge for all. Overlapping features in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) make diagnosis sometimes difficult. We aimed to classify clinical features and outcomes of proven AAV according to their serology, viz., anti-PR3/myeloperoxidase (MPO) by the enzyme-linked immunosorbent assay (ELISA). Materials and Methods: This was a prospective observational study of a total of 66 patients. This study included all consequent (old and new) AAV patients visiting a tertiary care center in northern India from August 2012 to June 2018. Patients were followed up for a minimum of 6 months. ANCA was done by both immunofluorescence assay and ELISA. Results and Conclusion: When compared, serological classification yielded findings similar to clinical counterparts [PR3/MPO vs. GPA/MPA]. The majority [80.3%] of patients were PR3-positive and were GPA clinically. Lung involvement was common in the PR3 group; however, there was no significant difference between the two groups [viz., PR3 and MPO, P = 0.18]. ENT involvement was significantly higher in the PR3 group when compared with the MPO group [P-value=0.009]. The difference in renal involvement in both the groups was not significant [P = 0.28]. Renal biopsy findings were similar in both the PR3/MPO groups. The median follow-up period was 18 vs. 12 months in the PR3 and MPO groups, respectively. Relapse was significantly higher in the PR3 group [P = 0.017]. The PR3 group significantly required rituximab for second induction treatment [P = 0.028]. Eight patients (12.12%) died during the study period. There was no significant difference in mortality, and there was permanent organ damage in both the PR3 and MPO groups. Autoantibody-based classification is supplemental to the clinical segregation of AAV phenotypes.

BackgroundStudies have shown a correlation between Tuberculosis (TB) and Takayasu arteritis (TA). Some even postulate that infection with TB is required for the initiation of aortoarteritis. Hence, this project was undertaken to find an association of TB and TA by studying the prevalence of Latent Tuberculosis Infection (LTBI) in Indian TA patients.ObjectivesTo study the prevalence of LTBI in Indian TA patients and see whether LTBI is more in these patients as compared to the historical cohort (40% in Indian population).MethodsThis was a cross sectional observational study. All consecutive patients with TA (satisfying the ACR 1990 criteria) were included prospectively from a period of May 2016 to December 2017. Their clinical, laboratory and radiological data were collected after obtaining informed consent. Patients were divided into groups based on the angiographic classification. LTBI was assessed by the Mantoux test and Quantiferon TB Gold test. Mantoux test (MT) was done with 5TU and results were read after 48–72 hours. An induration more than 10 mm was considered positive. Quantiferon TB Gold assay (QTB) was done by ELISA technique and (patient minus control) value >0.35 IU/ml was considered positive. A positive result of MT and /or QTB was considered positive for LTBI. Chest X-ray was included to access evidence of past or active TB lesions. Active infection was defined as clinical and microbiological and /or radiological evidence of TB. The study was approved by the Ethics committee of Medanta hospital.ResultsOut of 66 consecutive TA patients, 46 patients had tests available for LTBI and these were included in the analysis. The mean age of the cohort was 34.9 years with a median disease duration of 24 months. Males consisted of 11 patients whereas females formed the majority i.e. 35 patients (M: F= 1: 3.1). Angiographic Type V (54.3%) was the commonest in the cohort followed by Type IIB (17.3%), Type IV, I, IIA and III (15.2%, 8.6%, 2.1% and 2.1% respectively). LTBI positivity was present in 32.6% of the cohort; with 5 patients (10.8%) having both tests positive. 6 patients were MT positive without being QTB positive and 4 patients were only QTB positive. Eight patients had history of Tuberculosis out of which 1 was diagnosed with TB and TA simultaneously. Four patients were diagnosed as TA during the course of Anti tubercular treatment (ATT) between 4 to 6 months, whereas the rest were diagnosed after ATT completion. The mean duration of Anti tubercular treatment was 8 months. Koch’s contact was seen in 7 patients.Abstract FRI0507 – Table 1Patient characteristics and LTBICharacteristicValuePercentage (%) n=46MT positive only613QTB positive only48.6Both MT and QTB positive510.8LTBI positive1532.6n=8H/O TB8/4617.3TB LN450Pulmonary TB (progression)112.5Intestinal TB225TBM112.5Empirical ATT for PUO112.5MT225QTB00Both112.5n=7TB contact7/4615.2MT114.2QTB00Both00ConclusionsThe prevalence of LTBI in Indian Takayasu patients was 32.6%, which was not higher than the population prevalence (40% in the historical cohor...