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Background: The objective of the study was to assess clinical and imaging features of rheumatoid arthritis (RA) associated with interstitial lung disease (ILD), (RA-ILD) group, in comparison to RA without ILD (RA-C) and to identify the associated factors to ILD.Methods: This was a retrospective comparative study (June 2015 to March 2022) including RA patients aged ≥18 years. The RA-C control group was matched according to age (±2 years), gender, and RA duration (±2 years). General data, RA characteristics, ILD features, and treatment modalities were recorded. Statistical analysis was performed to determine the predictive factors of ILD.Results: A total of 104 patients were included (52 RA-ILD and 52 RA-C); sex ratio was 0.36. Mean age was 66.3±11 years (RA-ILD) versus 65.6±10.8 years (RA-C) (p=0.72). In comparison to RA-C, RA-ILD patients were significantly higher smokers (p=0.01) and physically inactive (p=0.01). Regarding RA features, RA-ILD patients have significantly increased positive anti-citrullinated peptide antibody (ACPA) (p=0.01), ACPA rate (p<0.001), erosive disease (p<0.001), and disease activity score (p<0.001). Mean time to ILD diagnosis was 5.85±7.16 years. Chest high-resolution computed tomography (HRCT) patterns of disease were identified: nonspecific interstitial pneumonia (NSIP) (28.8%), usual interstitial pneumonia (UIP) (17.3%), organizing pneumonia (OP) (25%), acute interstitial pneumonia (13.5%), and respiratory bronchiolitis (3.8%). Multivariate analysis identified smoking, high baseline DAS28 (disease activity score 28) and ACPA positivity as predictive factors of ILD.Conclusion: Our results confirmed the reported associated factors of ILD in RA (smoking, higher disease activity, ACPA positivity). Thus, we need to target the modifiable factors by supporting and educating RA patients to quit smoking and intensify disease modifying anti-rheumatoid drugs (DMARD) to reach remission.

BackgroundBrucellosis incidence has declined in developped countries, nevertheless it remains endemic in certains regions. Spondylodiscitis is the most frequent localisation of brucellosis infections complications, ranging from 30% to 85% according to cases series.ObjectivesThe aim of our study is to report the clinical and bacteriological features of this disease as well as its therapeutic profile.MethodsRetrospective study witch included medical records of patients treated for brucellar spondylodiscitis during the fifteen past years (2000–2014).ResultsNineteen cases were collected (12 males/ 7 females). Mean age was 52 years [rang 36 to 75]. All patients had at least a risk factor: exposed occupation in 6 cases, and unpastorized milk consumption in 12 cases). The following symtoms were observed: inflammatory back pain (14 cases), inflammatory dorsal pain (4 cases), raduculalgia with neurological signs were (1 cases), weight loss (13 cases), fever (14 cases), night sweating (4 cases), C Reactive protein was increased in 2 cases. Lymphopenia was noted in 1 case. Wright serology was positive in all cases. Standard X-ray showed narrowing in disc space in 5 cases, endplate destuction in 9 cases and bone condensation in 3 cases. MRI performed in 14 cases, showed Low signal on T1 weighted images and high signal on T2 weighted images of the vertebral bodies and intervertebral disc. Moreover it revealed epidural extension (5 cases) abcess formation (2 cases) and psoas abcess (6 cases). All patients were treated by association of antibiotics (doxycicline and rifampicin) for 2 to 3 months. Evolution was farorable with resolution of pain, normalization of biological inflammation and slow radiologic reconstruction in 10 cases. For one patient treatment was prolongated to one year due to the persistance of an epiduritis in the follow-up MRI.ConclusionsPrognosis of brucellar spondylodiscitis seems good under appropriate treatment. Nevertheless primary prevention is still necessary especially in countries where brucellosis is endemic.Disclosure of InterestNone declared