AB1147 Evolutionary study of 45 cases of undifferentiated negative hla b27 seronegative oligoarthritis

Abstract

BackgroundThe prognosis of patients with undifferentiated arthritis may vary from self-limited to severe destructive rheumatoid arthritis. Early diagnosis is important, specially in seronegative oligoarthritis in order to start a treatment as early as possible.ObjectivesTo describe the evolution of patients older than 16 years diagnosed with negative HLA B27 seronegative oligoarthritis without axial involvement.MethodsWe retrospectively studied 45 patients (23 women, 22 men) with negative HLA B27 seronegative oligoarthritis without axial involvement who debuted between 1985 and 1990 and who did not meet the criteria for any of the rheumatic diseases at the time of debut: rheumatoid arthritis (AR), psoriatic arthropathy (PsA), spondyloarthropathy, enteropathic arthritis, reactive arthritis, microcrystalline arthritis or connective tissue disease.ResultsThe mean age at onset of oligoarthritis was 42.2 years (range 17–66). The mean follow-up time was 13.7 years (range 1–32). In its evolution, a definitive diagnosis was reached in 21 (46.6%) patients, with the mean time between debut and diagnosis being 5.47 years (range 1–25): 8 AR, 4 APs (3 with involvement) peripheral and 1 mixed), 2 undifferentiated spondyloarthritis, enteropathic arthritis, 5 gouty arthropathies and one SLE. In the case of RA, the diagnosis was made on an average of 4.8 years after the debut (range 1–16); the RF was positive in 4 patients a mean of 7.6 years (range 3–11) after the debut, and the anti-CCP were positive in 3 of the patients with positive RF. Within PsA, one developed skin psoriasis, another psoriatic onicopathy at 4 years after debut and 2 continue without skin involvement but with a family history of psoriasis, all met CASPAR criteria. From the other 24 patients (53.3%), only 3 patients (12.5%) continued to be followed up, with an average of 21.3 years (range 18–26) without meeting the criteria that allow us to define diagnosis. With the rest of the patients (40.8%), followed for an average of 4.5 years, a diagnosis was not achieved by resolution of the clinical picture or loss of follow-up.ConclusionsIn our series, 46.6% of the patients with a diagnosis of negative HLA B27 seronegative oligoarthritis began to meet diagnostic criteria for rheumatic disease after a mean time of 5.47 years, with RA being the most frequent diagnosis (38%) after an average of 4.8 years after the arthritis onset.Reference[1] K.N. Verpoort, H. van Dongen, C.F. Allaart, R.E.M. Toes, F.C. Breedveld, T.W.J. Huinzinga. Undifferentiated arthritis-Disease course assessed in several inception cohorts. Clin Exp Rheumatol2004;22 (Suppl.35):S12-S17.Disclosure of InterestNone declared

Characterisation of prodromal and very early psoriatic arthritis: a systematic literature review informing a EULAR taskforce

“… 34 Furthermore, the authors found that UA later developing PsA, when compared with UA later developing rheumatoid arthritis (RA), had more mono-oligoarthritis and the articular disease was more localised and intermittent. In Exposito-Perez et al, 36 peripheral involvement was present in all new PsA diagnosis. Regarding imaging at PsA onset, data were derived only in one study, Paalaneen et al (PsA cases, n=46) in which juxta-articular new bone formation were found in 20% and pencil in cup deformities in 5%.…”

“…Regarding UA/PsA transition, of 7873 references focusing on UA to PsA, 3 studies were included of which 1 was a retrospective cohort study, 1 a case-control study and 1 in abstract form. [34][35][36] The PRISMA flow chart is shown in figure 2. The breakdown presentation of the included studies is available in online supplemental file 2.…”