Scientific Abstracts [2] Clin Exp Rheumatol. 2010 May-Jun;28(3):297-9. [3] Lupus. 2005;14(12):938-46. [4] Clin Exp Rheumatol. 2004 Nov-Dec;22(6):713-21. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.5701 AB0589 INVOLVEMENT OF PERIPHERAL NERVOUS SYSTEM IN PRIMARY SJÖGREN SYNDROME. A GESSAR ANALISYS M.M. Mayer 1 , S.D. Velez 1 , F. Zazzetti 1 , L. Galván 1 , G. Bennasar 2 , L.R. Carlevaris 2 , A. Secco 2 , C. Asnal 3 , P. Pucci 3 , C. Amitrano 3 , A. Nitsche 3 , M.C. Khoury 4 , F. Caeiro 5 , N. Benzaquén 5 , J.P. Pirola 5 , M. Colazo 5 , O.L. Rillo 6 , S. Papasidero 6 , J. Demarchi 6 , L. Raitti 7 , M.N. Tamborenea 8 , M.L. Santiago 8 , P. Alba 9 , B. Busamia 9 , G. Salvatierra 10 , A. Catalán Pellet 2 , J.C. Barreira 1 on behalf of GESSAR. 1 Rheumatology, Hospital Britanico de Buenos Aires; 2 Rheumatology, Hospital Rivadavia; 3 Rheumatology, Hospital Alemán; 4 Statistics, Hospital Britanico de Buenos Aires, Buenos Aires; 5 Rheumatology, Hospital Privado, Córdoba; 6 Rheumatology, Hospital Tornú; 7 Rheumatology, Clinica Bessone; 8 Rheumatology, OMI, Buenos Aires; 9 Rheumatology, Hospital Córdoba, Córdoba; 10 Rheumatology, IPRI, Santiago del Estero, Argentina Background: Peripheral neuropathy (PN) is usually is a late onset event in primary Sjögren Syndrome (pSS) associated with purpura, cryoglobulinemia, hypocomplementemia and increased risk of lymphoma. Objectives: To describe the frequency of PN in patients with pSS and identify related factors. Methods: Adult patients in the GESSAR database who met 2002 criteria for pSS. Demographic, clinical, laboratory and electromyogram (EMG) findings were recorded. PN was defined with clinic manifestations and EMG. Other causes of PN were excluded. To compare groups, all patients with PN were included (cases) and a random sample of patients without PN (controls) with a 1:4 ratio was used. Mann-Whitney was used for numeric variables and χ2 or Fisher’s for categorical. An α of 0.05 was considered significant. Results: Of 368 patients, 95% were female. Mean age at analysis was 55 y/o (21-87) and 50 y/o (20-89) at diagnosis. The frequency of PN was 11.68% (43/368). Sensory PN was found in 63% (28/43), predominantly small fibers involvement in 41.8% (18/43), axonal PN in 20.9% (9/43) and ataxic in 2.3% (1/43). Somatosensory manifestations were found in 37% (16/43) with axonal involvement in 30.2% (13/43) and mononeuritis multiplex in 6.9% (3/43), none had autonomic PN. When comparing groups (43 vs 172 controls) patients with PN had a higher frequency of vasculitis (11.7% vs 1.7%; p=0.002), purpura (23.8% vs 4.7%, p=0.0001), renal tubular acidosis (7.6% vs 1.2%, p=0.020), leucopenia (30.7% vs. 12.1%, p=0.005), low C3 (48.5% vs. 10.3%, p=0.0001) and C4 (66.6% vs. 18.2%, p=0.0001), (+) Anti-Ro/SSA (85.3% vs. 66.6%, p=0.019), (+) RF (72.5% vs. 52.1%, p=0.022), cryoglobulinemia (42.1% vs. 10.9%, p=0.0001) and higher frequency of hypergammaglobulinemia (60.5% vs 44.6%, p=0.09), Raynaud’s (27.5% vs 11.6%, p=0.051) and glomerulonephritis (4.6% vs 0.5%, p=0.018), although without statistical significance. Conclusions: The frequency of PN was 12%, similar to other cohorts. Small fibers and axonal somatosensory PN were the most common. PN was significantly associated with vasculitis, purpura, renal tubular acidosis, cryoglobulinemia, leucopenia, hypocomplementemia and anti-Ro and RF positivity. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.1625 AB0590 PROLACTIN LEVELS ARE ASSOCIATED WITH A PRO-INFLAMMATORY BODY MASS DISTRIBUTION AMONG SYSTEMIC LUPUS ERYTHEMATOSUS FEMALE PATIENTS M.F. Ugarte-Gil 1,2 , R.V. Gamboa-Cardenas 1 , F. Zevallos 1 , J.M. Cucho-Venegas 1 , R.A. Perich-Campos 1,3 , J.L. Alfaro-Lozano 1 , M. Medina 1 , Z. Rodriguez-Bellido 1,3 , G.S. Alarcón 4 , C.A. Pastor-Asurza 1,3 . 1 Rheumatology, Hospital Nacional Guillermo Almenara Irigoyen, Essalud; 2 Universidad Cientifica del Sur; 3 Universidad Nacional Mayor de San Marcos, Lima, Peru; 4 The University of Alabama at Birmingham, Birmingham, United States Background: Chronic inflammatory conditions are associated with a decrease of bone mineral density (BMD) and lean mass (in particular low appendicular lean mass) and an increase of fat mass (in particular areas considered more pro-atherogenic, like trunk fat mass or trunk-to-leg fat ratio). As prolactin (PRL) has a pro-inflammatory function in systemic lupus erythematosus (SLE) and it is associated with disease activity and damage, it would be expected that PRL could be associated with a decrease of BMD and lean mass and an increase of fat mass. Objectives: To determine whether PRL levels are associated with a proinflammatory body mass distribution in female SLE patients. Methods: This cross-sectional study was conducted in consecutive SLE female patients seen in our Rheumatology Department from 2012 to 2014. For the purpose of this study, baseline visits were included. Overweight patients (more than 115 kg), those with metallic implants or pregnant were excluded for this analysis. Disease activity was ascertained using the SLEDAI and disease damage with the SLICC/ACR damage index (SDI). PRL was measured in ng/ml. Body mass distribution was measured by DXA and it was divided into sub-total 1097 (whole body without the head) BMD, sub-total bone mineral content (BMC), lean mass index (appendicular lean mass/height2 , LMI), sub-total, trunk and leg fat percentages and trunk-to-leg fat ratio. A pro-inflammatory body mass distribution is defined as a decrease of BMD, BMC and LMI and an increase of fat mass, in particular trunk fat mass and trunk-to-leg fat mass ratio. The association between PRL levels and body mass distribution components was evaluated by univariable and multivariable linear regression models, the last one adjusted for age, disease duration, SLEDAI, SDI, use of prednisone, antimalarials and immunosuppressive drugs. Results: One hundred and fifty-five patients were evaluated; their mean (SD) age was 42.7 (13.4) years; nearly all patients were Mestizo. Patients included in this study had a lower body mass index than the rest of the cohort. Age, disease duration, SLEDAI and SDI were similar than the rest of the cohort. Disease duration was 7.3 (6.6) years. The SLEDAI was 5.5 (4.1) and the SDI 0.8 (1.3). PRL levels were 18.8 (14.3) ng/ml. BMD was 0.9 (0.1) g/cm2 , BMC was 1.4 (0.3) kg, LMI 6.1 (1.1) kg/m2 , percentage of subtotal fat 36.7 (6.7), trunk fat 34.3 (7.6), leg fat 37.9 (6.7), trunk-to-leg fat ratio 1.5 (0.6). Multivariable analysis is depicted in Table 01. Table 1. Association between PRL level (per each 10 ng/ml increase) and body mass distribution BMD BMC LMI Subtotal fat mass percentage Trunk fat mass percentage Leg fat mass percentage Trunk-to-leg fat ratio B (CI 95%) P value −0.012 (−0.023; −0.001) −0.037 (−0.069; −0.004) −0.188 (−0.335; −0.042) −0.077 (−0.931; 0.776) 0.049 (−0.911; 1.009) −0.303 (−1.187; 0.580) 0.143 (0.069; 0.218) 0.035 0.028 0.013 0.858 0.920 0.498 <0.001 Conclusions: Higher PRL levels are associated with a pro-inflammatory body mass distribution in SLE patients. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.2759 AB0591 ORGAN DAMAGE EVALUATION AND RISK FACTORS IN A COHORT OF 511 SLE PATIENTS M. Taraborelli, N. Martinazzi, M.G. Lazzaroni, L. Andreoli, M. Fredi, Y. El Masri, S. Cartella, I. Cavazzana, M. Taglietti, M. Frassi, F. Franceschini, A. Tincani. Rheumatology, Spedali Civili, Brescia, Italy Background: Systemic lupus erythematosus (SLE) is still burdened by a significant morbidity and mortality. Objectives: To determine the prevalence of organ damage, with related risk factors, and mortality in a cohort of SLE patients. Methods: The clinical records of patients fulfilling the American College of Rheumatology (ACR) criteria for SLE, followed for at least 1 year in our center were retrospectively reviewed. Organ damage was assessed by the Systemic Lupus International Collaborating Clinics/ACR Damage Index (DI) at 1 year after diagnosis and then every 5 years, from the beginning until the end of the follow-up in our center. Disease activity was measured by the SLE Disease Activity Index Scientific Abstracts 1098 (SLEDAI) 2K at the beginning of the follow-up. The comparison of characteristics between patients with and without damage at the end of their follow-up was performed by the Chi Square’s, Fisher’s exact and Student’s t test as appropriate; p<0.05 was considered significant. Results: This study included 511 SLE patients (92% females, 95% Caucasians), followed in our Unit between 1972 and 2014, with a mean age at diagnosis of 33 years (±13) and a mean disease duration at the end of the follow-up of 16 (±9) years. One year after diagnosis 40% of patients with measurable DI (n=400) had accrued some damage and its prevalence gradually increased over time (Table I). At 1 year ocular (13%), central nervous system (12%) and skin (8%) damage were the most frequent whereas ocular, skin and musculoskeletal were the most frequent sites of damage (40%) at 35 years. Different features were significantly associated to damage (Table II). The main causes of death in 35 patients (7%) were cancer (33%) and organ failure (22%) after a mean disease duration of 13 years. Conclusions: The organ damage that accumulates over time in SLE is partly linked to disease activity, partly defined by clinical profiles (neuro-SLE, renal disease and Antiphospholipid Syndrome) that may require aggressive treatments. New, more effective and less toxic drugs could limit the progression of this process. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.4754 AB0592 ROLE OF IMMUNOGLOBULIN AND COMPLEMENT DEPOSITS IN ACTIVITY, CHRONICITY AND CLASSES OF LUPUS NEPHRITIS M.U. Martinez Martinez 1 , A.N. Rangel-Botello 1 , G. Felix-Rodríguez 1 , H.E. Esparza-Holguín 1 , D.A. Herrera-van Oostdam 1 , D. Martínez-Galla 2 , C. Abud-Mendoza 1 . 1 Unidad de Investigaciones Reumatológicas; 2 Departamento de Patología, Hospital Central “Dr. Ignacio Morones Prieto”, Universidad Autónoma de San Luis Potosí, San Luis Potosi, Mexico Background: Immune deposits for immunoglobulin (Ig) classes (IgG, IgM and IgA) and complement components (C3 and C1q) are a main feature of lupus nephritis (LN). The glomerular intensity of these deposits can be associated with the pathogenesis and prognosis of LN. Objectives: The main objective of this study was to evaluate the association of the intensity of Ig and complement deposits with activity, chronicity (Austin et al.1 ) and the classes of LN (ISN/RPS classification). Methods: Registries of all biopsies of LN performed the last five years were evaluated. All biopsies were classified according to the ISN/RPS classification; immunofluorescences were semi-quantitatively graded from 0 to 4 according to the intensity of fluorescence. Activity and chronicity indices (AI and CI) were recorded for proliferative classes (class II, IV or their combinations) according to Austin et al.1 Correlation was evaluated through Spearman’s rho (r), and non-parametric statistics were performed for continuous variables. Results: We included 90 biopsies of LN patients: 3 class I, 4 class II, 7 class III, 15 class III/V, 29 class IV, 17 class IV/V and 15 pure class V. For the 68 proliferative LN biopsies (class III, IV and combination with V) the median (IQR) activity was 7 (4-11) and chronicity 3 (1-5). Ig and complement deposits were similar between the classes of LN. Correlation between activity and intensity of Ig or complement components were: IgM r=0.35 (p=0.006), IgA r=0.0211 (p=0.873), IgG r=0.069 (p=0.599), C1q r=0.239 (p=0.065), and C3 r=0.168 (p=0.195). Correlation between chronicity and Ig or complement components were as follows: IgM r= -0.109 (p=0.384), IgA r=0.295 (p=0.017), IgG r=-0.132 (p=0.288), C1q r=-0.136 (p=0.276), C3 r= -0.200 (p=0.104). Figure 1 shows the positive association between IgM and activity of LN. Figure 1. Intensity of IgM deposits and activity in kidney biopsy. Conclusions: The positive association between activity of LN and IgM, suggests that this immunoglobulin may participate in both prognosis and the histologic changes described for activity of LN such as proliferation, cellular crescents, interstitial inflammation and others. References: [1] Austin H, et al. Kidney Int 1984;25:689-95 Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.5313 AB0593 NON-TYPHOID SALMONELLA INFECTIONS IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS. A RETROSPECTIVE, 20 YEARS STUDY M. Olejárová 1,2 , V. Henyšová 3 . 1 Institute of Rheumatology, Praha 2; 2 Clinic of Rheumatology, Ist Medical Faculty, Charles University; 3 1st Medical Faculty, Charles University, Praha, Czech Republic Background: Non-typhoid salmonellosis is a frequent infection complication in SLE. The extraintestinal manifestations and sepsis are more frequent in SLE than simple gastroenteritis. SLE was identified to be an important risk factor of salmonella generalisation together with glucocorticosteroids treatment or liver cirrhosis. Objectives: The objective of the study was to study the SLE patients with the history of non-typhoid salmonellosis and to determine the population in the highest risk. Methods: A retrospective study of the medical database of the Institute of Rheumatology over the years 1995-2015 was performed. All SLE patients who undergone non-typhoid salmonellosis were identified. The patients who did not fulfill the classification criteria of SLE or had non-typhoid salmonellosis in the past were not included into the study. In the patient, the demographic and clinical data were collated and the activity using SLEDAI and damage (SLICC) were evaluated. Results: We have identified 20 SLE patients, 3 males and 17 females in which the non-typhoid salmonellosis was confirmed. Mean age of the group was 35,9±12,2 years, mean duration of the disease 5,4±7,1years. Only 6 patients experienced gastroenteritis, 3 patients had urinary infection, 2 had septic gonitis, 6 had sepsis, 2 had infected skin defects and 1 had absces of a lower limb. The detailed clinical and laboratory data were available in 18 patients, in which the activity and damage were evaluated. The activity of the group was high (SLEDAI 10,9±6,6), but the SLICC was only 1,1±1,0. We have identified two different types of SLE patients. First was a group of patients with severe SLE disease (lupus nephritis, vasculitis), high activity and usually treated with high doses of glucocorticosteroids. In the other subgroup of patients (n=5) the salmonellosis induced the symptoms SLE which was later diagnosed, or in one case of patient with RA induced an overlap of RA and SLE. Conclusions: The non-typhoid salmonellosis is a relativelly common agent of infective complications of SLE. It may result from an immunodeficiency due to SLE or treatment with immunosupressive drugs including GC, but on the other hand, the salmonellosis may be also a triggering moment of induction or flare of lupus. Every patient with salmonella infection should be treated very carefully. Acknowledgements: This work was supported by the project (Ministry of Health, Czech Republic) for consensual development of research organization 023728. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.6391 AB0594 THE METABOLIC SYNDROME IN CHINESE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND ITS ELEVATED LEVELS OF LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2 M. Qiu, Z. Hu, X. Guo, J. Gu. Rheumatology, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Background: Metabolic Syndrome (MS) may contribute to increased cardiovascular risk in the population. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is involved in the modification of lipids within atheromatous plaques. The increased prevalence of MS in SLE patients has been reported. However, few studies report the prevalence of MS in patients with SLE in southern China, and no study reveals its association with Lp-PLA2. Objectives: To investigate the prevalence and clinical features of MS in patients with SLE in southern China, and to evaluate its association with Lp-PLA2. Methods: 415 inpatients with SLE diagnosed in our Rheumatology Department from 2012 to 2014 were retrospectively investigated for their incidence of MS, compared with 830 age- and gender-matched general individuals. MS was defined according to the 2009 consensus statement of the International Diabetes Foundation.Data of medical records review, physical examination and laboratory tests were collected. Furthermore, SLE patients were classified according to the prevalence of MS. Plasma Lp-PLA2 level, SLE disease activity index (SLEDAI) and lupus characteristics were compared between SLE group with MS and SLE group without MS. Results: There were 140 patients with SLE presented MS. The prevalence of MS in the cohort was 33.73% (140/415), significantly higher than that of the matched controls (14.22%, 118/830, P<0.05), the same both in males (30.51% vs 20.0%) and females (34.27% vs 13.27%) (P<0.05). However, no significant difference was found regarding the incidence of MS between male and female groups with SLE (30.51% vs 34.27%, P>0.05). The MS component with the highest prevalence in the SLE population was low HDL-Cholesterol (<50mg/dL) with a prevalence of 58.60%. And the ratios of patients with higher TG, higher LDL-C and impaired fasting glucose in SLE group were 33.12%, 31.74% and 19.11% respectively. The incidence of MS in the age group (44 years old) with SLE was significantly higher than that of the age-matched controls (28.45% vs 10.37%, P<0.05), but we found no significant difference in the age ranges of both 45–64 years and 65 years (P>0.05). The plasma Lp-PLA2 level of SLE group with MS was significantly higher than that of SLE group without MS (497.40 vs 324.65,