Ab0037 undifferentiated Arthritis

Abstract

Background:Early recognition and treatment of inflammatory arthritis is imperative for the further course of the disease.Objectives:This study aims to determine the evolution of undifferentiated arthritis observed in rheumatology.Methods:Retrospective descriptive study which collects patients files identified as undifferentiated Arthritis and followed in the Rheumatology Department at Fattouma Bourguiba Hospital Monastir TUNISIA over a period of 15 years (2005, 2019). Epidemiological, clinical, paraclinical, and evolutionary data were collected and analyzed.Results:99 files were analyzed. The average age was 42.06±15.56; they were 42 males and 57 females with an average body mass index of 27±6.1 Kg/m2. The reason leading to consultation was, polyarthritis (37), oligoarthritis (27), mono-arthritis (21), and polyarthralgia (15). The median time to visit was 60 days [15 days, 3 months]. The median number of painful joints and swollen joints was 4 [2, 8], and 2 [1, 4] respectively. The mean duration of morning derusting was 34.8 ±24.4 minutes. Extra-articular manifestations were: a dry syndrome (22), a rheumatoid nodule (2), and serosal damage (1). Anemia (52 patients), leukopenia (6 patients), and lymphopenia (13 patients) were found in the blood cell count with a biological inflammatory syndrome in most patients (72/99). The immunology results showed: positive anti-nuclear antibodies (15/99), positive Anti-Citrullinated Protein Antibodies (9/99) and positive rheumatoid factor (8/99). 31 patients had standard radiological signs represented mainly by joint pinching and erosions. A joint puncture was done in 36/99 revealing inflammatory fluid in most cases. After an average follow-up of 1047 days [365, 1460]. undifferentiated arthritis was classified as rheumatoid arthritis (RA) (23), spondyloarthritis (SpA) (10), connective tissue disease (11), Crystalline Arthritis (5), and paraneoplastic arthritis (2). One patient had self resolution of symptoms and 38 remain undifferentiated.we found that the more the patients were seropositive, the more likely to develop Rheumatoid Arthritis (p=0.001), the more there was disorder in the blood cell count, the more the evolution was towards connective tissue disease (0.01), The more male patients were, the more likely to develop SpA (p=0.04). The patients management was mainly based on: analgesics (94), systemic corticosteroids (57) with a mean dose of 10.89± 5.8 mg/day. The use of Methotrexate and antimalarial drugs was noted in 18 and 15 patients respectively.Conclusion:Follow-up of patients with undifferentiated arthritis leads to a definite inflammatory rheumatism diagnosis in 61.6% of cases. Our data indicate that seropositive patients with chronic symptoms carry an increased risk of developing Rheumatoid Arthritis (P=0,001). Clinical, biological and genetic data can help the health care provider to predict future outcomes.References:[1]DOI: 10.1007/s00132-018-3539-2.Disclosure of Interests:None declared