“Puffy hand syndrome”

Resume La toxicomanie intraveineuse est responsable de nombreuses complications notamment cutanees et infectieuses. Il existe un syndrome rarement observe en rhumatologie se traduisant par des « grosses mains » : le puffy hand syndrome. Nous en rapportons deux cas rencontres en consultation de rhumatologie chez deux patients toxicomanes. Il s’agit d’un œdeme des mains, bilateral, indolore, ne prenant pas le godet, survenant chez un de nos patients pendant l’intoxication par heroine, et chez l’autre 2 ans apres avoir arrete ses injections. Chez nos deux patients les bilans complementaires (biologiques, radiologiques, echographiques) etaient sans particularite, ce qui a permis dans le context…

Deaths Associated with Ankylosing Spondylitis in France from 1969 to 2009.

Objective.To describe deaths for which ankylosing spondylitis (AS) was on death certificates in France.Methods.Death certificates in which AS was indicated were evaluated. Standard mortality ratio (SMR) was assessed.Results.AS appeared in 2940 death certificates. The mortality rate of AS seemed stable. The most frequent initial causes were diseases of the circulatory system [28.3% in the International Classification of Diseases, 10th ed (ICD-10)]. SMR adjusted for age and sex were 2.1 (95% CI 1.45–2.91) for infections and 0.43 (0.36–0.5) for cancers (ICD-10 period).Conclusion.This study found an increase in mortality from infectious and external causes of death; conversely, patients with AS…

FRI0044 Non-steroidal anti-inflammatory drugs are more beneficial than anti-tnfα drugs on the radiographic damage in arthritis: a study in adjuvant induced arthritis

Background The management of the chronic inflammatory rheumatisms has dramatically evolved in the last decade with a concept of “treat to target”. The theory of a window of opportunity with more beneficial effects of an early intensive treatment is supported by several evidences. The positive impact of an early treatment with a TNFα blocker is expected but the place and the interest of non-steroidal anti-inflammatory treatments (NSAIDs) and glucocorticoids is not clear. Objectives The aim of this study was to evaluate the radiological outcomes after an early treatment during 21 days by Etanercept, or Naproxene, or Celecoxib, or Prednisone, or Diclofenac or Methotrexate in adjuvant induced a…

AB0438 Safety of tnf blockers in case of non-alcoholic fatty liver disease and cirrhosisa systematic review

Background The management of inflammatory rheumatisms and psoriasis has largely evolved over the last 15 years with the emergence of biotherapies whose main adverse effect is the increased infection risk. The prevalence of metabolic syndrome is increasing and has been estimated at 30% in patients with rheumatoid arthritis with an excess of 45% compared to healthy subjects. One of the major complications of the metabolic syndrome is the Non Alcoholic Fatty Liver Disease (NAFLD), which prevalence is 25% in the global population, and 30% in a cohort of patients with rheumatoid arthritis. The main complication of NAFLD is the development of cirrhosis, known to increase infectious risk. Surprisi…

Performances diagnostiques de l’IRM des sacro-iliaques et du rachis pour le diagnostic de spondyloarthrite axiale non radiographique chez des patients avec rachialgies inflammatoires chroniques

Resume Objectif Le manque de specificite des criteres IRM de l’ASAS pour la spondylarthrite axiale non radiographique (SpA ax NR) justifie d’evaluer la capacite discriminante d’autres anomalies IRM au niveau des sacro-iliaques (SI) et du rachis. Methodes Chez des patients hospitalises pour lombalgies inflammatoires, les performances diagnostiques (sensibilite, specificite, rapport de vraisemblance positif (RVP)) des anomalies IRM ont ete calculees en prenant l’avis d’experts rhumatologues comme reference : (i) sacro-iliaques : œdeme (nombre et localisation), œdeme etendu > 1 cm (deep lesion), metaplasie graisseuse (nombre), erosion (nombre et localisation), backfill ; (ii) rachis dorso-lomb…

Atteinte des vaisseaux dans les spondyloarthrites axiales

Resume La spondylarthrite ankylosante est un rhumatisme inflammatoire chronique caracterise par une atteinte des entheses entrainant des douleurs inflammatoires et une impotence fonctionnelle. La spondylarthrite est associee potentiellement a des manifestations extra-articulaires (uveite, psoriasis, maladie intestinale chronique inflammatoire) et des comorbidites (cardiovasculaire et osteoporose) qui en font avec l’ankylose, la gravite de cette maladie. Comme de nombreuses maladies systemiques inflammatoires, il existe une surmortalite liee a une atteinte cardiovasculaire responsable d’un sur-risque d’infarctus du myocarde, d’accidents vasculaires cerebraux et d’evenements thromboemboliques…

THU0406 ULTRASONOGRAPHIC INVOLVEMENT OF THE ANTERIOR CHEST WALL IN SPONDYLOARTHRITIS, A FIVE YEARS FOLLOW UP STUDY

Background Spondyloarthrits is characterized by inflammatory back pain. Anterior chest wall pain is common and a previous study reported a prevalence a 37% of ultrasonographic lesions of this anatomical region [1]. Objectives The objective of this study is to evaluate, in patient with Spondyloarthritis, the prevalence of ACW ultrasonographic lesions after a follow up of 5 years and to identify factors associated with the development of new lesions. Methods This a monocentric and prospective study including patients with Spondyloarthritis meeting the ASAS 2009 criteria. Patients were followed during five years. ultrasound B mode and power Doppler examination of the two sternoclavicular joint…

Calprotectin and spondyloarthritis

Risque cardiovasculaire dans le rhumatisme psoriasique : revue narrative

Resume Introduction Le rhumatisme psoriasique (PsA) est un rhumatisme inflammatoire chronique caracterise de longue date par un risque cardiovasculaire important. Au cours des dernieres annees, les donnees epidemiologiques ont quelque peu change depuis l’utilisation croissante de biomedicaments efficaces pour reduire cette inflammation. L’objectif de cette revue est d’evaluer les donnees actuelles sur la morbidite et la mortalite cardiovasculaires dans le PsA et d’evaluer le risque cardiovasculaire en cas de PsA. Methode Nous avons effectue une revue de la litterature sur les bases de donnees Pubmed et Medline en utilisant les mots cles suivants : « Psoriatic Arthritis » et « Cardiovascular…

Effet de la cryothérapie locale sur l’inflammation vasculaire, la dysfonction endothéliale et l’activation endothéliale en cas d’arthrite

Introduction La polyarthrite rhumatoide (PR) est caracterisee par une surmortalite d’origine cardiovasculaire, qui est la consequence d’une dysfonction et d’une activation endotheliales (infiltration vasculaire par les cellules de l’immunite), et d’une inflammation vasculaire. Ces dernieres annees, un regain d’interet pour la cryotherapie locale ou corps entier en tant que therapie d’appoint a emerge. Alors que des donnees existent en faveur d’un effet positif de la cryotherapie locale sur la douleur et l’activite de la maladie, l’effet de ce type de strategie sur le risque cardiovasculaire est pour l’instant inconnu. L’objectif de notre etude a ete d’evaluer l’effet d’un traitement par cry…

AB0266 METHOTREXATE AND CARDIOVASCULAR RISK IN RHEUMATIC DISEASES:A COMPREHENSIVE REVIEW

Background:The management of inflammatory rheumatic disease has evolved in the last decade with the importance of the management of comorbidities. Methotrexate is the cornerstone of inflammatory rheumatic disease management, but its cardiovascular effects are still poorly understoodObjectives:To assess the cardiovascular impact of methotrexate in inflammatory rheumatic disease.Methods:A systematic review of the literature, following the prisma recommandations, was performed on the PubMed and Embase databases with the following keywords: (“Methotrexate”) AND (“cardiovascular”). We included papers written in English and including patients older than 18 years.Results:570 references were identi…

Cardiovascular risk in psoriatic arthritis, a narrative review

Abstract Introduction Psoriatic arthritis (PsA) is a chronic inflammatory rheumatism characterized for a long time by a high degree of cardiovascular risk. Chronic inflammation is one of the mechanisms that explain this cardiovascular excess of risk through direct and indirect pathways. In recent years, epidemiological data have changed somewhat since the increasing use of bio-drugs that are effective in reducing this inflammation. The purpose of this review is to assess the current state of cardiovascular morbidity and mortality in PsA and thus to assess the cardiovascular risk in case of PsA. Method We conducted a literature review using Pubmed and Medline databases with the following key…

Immunogenicity of TNF alpha inhibitors in rheumatology: many questions, enough answers?

Aerobic exercise for axial spondyloarthritis - its effects on disease activity and function as compared to standard physiotherapy: A systematic review and meta-analysis

Aim To evaluate the impact of an aerobic fitness program on disease activity, defined by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and on C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in case of axial spondyloarthritis. Methods A systematic review of the literature, following the Prisma recommendations, was performed by two reviewers on the PubMed and Embase databases. Controlled trials assessing the efficacy of aerobic exercises compared to physiotherapy on axial spondyloarthritis disease activity were included. The diagnosis of axial spondyloarthritis was meeting the New York criteria and/o…

Impact of glucocorticoids on systemic sirtuin 1 expression and activity in rats with adjuvant-induced arthritis

The class III histone deacetylase sirtuin 1 (SIRT1) plays a pivotal role in numerous biological and physiological functions, including inflammation. An association between SIRT1 and proinflammatory cytokines might exist. In addition to their important role in inflammation associated with rheumatoid arthritis (RA), proinflammatory cytokines mediate the development of systemic effects. Here, we evaluated systemic SIRT1 expression and enzymatic activity, in peripheral blood mononuclear cells (PBMCs) and in liver isolated from rats with adjuvant-induced arthritis (AIA), treated or not with low or high doses of glucocorticoids (GCs). We also measured the production of tumour necrosis factor alph…