AUTOANTIBODIES AND CLINICAL FEATURES CAN PREDICT EVOLUTION IN PATIENTS WITH MIXED CONNECTIVE TISSUE DISEASE (MCTD)

S. Cappelli, S. Bellando-Randone, D. Martinović, M.-M. Tamas, K. Pasalić, Y. Allanore, M. Mosca, R. Talarico, D. Opris, C. Kiss, A.-K. Tausche, S. Cardarelli, V. Riccieri, O. Koneva, G. Cuomo, M.O. Becker, A. Sulli, S. Guiducci, M. Radić, S. Bombardieri, M. Aringer, F. Cozzi, G. Valesini, L. Ananieva, G. Valentini, G. Riemekasten, M. Cutolo, R. Ionescu, L. Czirják, N. Damjanov, S. Rednic, M. Matucci CerinicDepartment of Medicine, Division of Rheumatology, University of Florence, Florence, Italy Department of Rheumatology, Internal Clinic, University of Split, Split, Croatia Department of Rheumatology, "Iuliu Hatieganu", University of Medicine and Pharmacy, Cluj-Napoca, Romania Institute of Rheumatology, University School of Medicine, Belgrade, Serbia Hôpital Cochin, Service de Rheumatologie A, Universitè Paris Descartes, Paris, France Department of Internal Medicine, Division of Rheumatology, University of Pisa, Pisa, Italy Spitalul Santa Maria, UMF Carol Davila, RCRD, Bucharest, Romania Department of Rheumatology and Immunology, Clinic Center, University of Pécs, Pécs, Hungary Division of Rheumatology, Department of Medicine III, University Center Carl Gustav Carus, Technical University of Dresden, Dresden, Germany Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padua, Padua Division of Rheumatology, Department of Medical Clinic and Therapy, ``La Sapienza'' University of Rome, Rome, Italy State Institute of Rheumatology of RAMS, Moscow, Russian Federation Division of Rheumatology, University of Neaple II, Neaple, Italy Department of Rheumatology and Clinical Immunology, Medical Faculty of the Charité, Berlin, Germany Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova Department of Medicine, Division of Rheumatology, University of Florence, Florence, Italy Institute of Rheumatology, University School of Medicine, Belgrade, SerbiaObjectives: To define predictors (autoantibodies and clinical features) of evolution towards other connective tissue diseases (CTDs) in patients with the initial diagnosis of mixed connective tissue disease (MCTD) and to find out associations between autoantibody pattern at disease onset and development of a specific organ involvement during the course of the disease. Methods: Clinical and serological features of 161 patients with the initial diagnosis of MCTD were evaluated retrospectively at the diagnosis and in 2008, after a mean disease duration of 7.9 years. Patients who satisfied at diagnosis either classification criteria for Kasukawa, Alarcόn or Sharp have been evaluated separately and reclassified in 2008 according to their evolution. Statistical analysis were performed to find out predictors of evolution into other CTDS and of development of a specific organ involvement. Results: Anti-dsDNA positivity turned out to be associated with evolution into systemic lupus erythematosus (SLE) both in patients with a first diagnosis of MCTD according to Kasukawa (p=0.012) and Alarcόn-Segovia criteria (p=0.001). Sclerodactyly (p=0.034) and esophageal hypomotility or dilatation (p<0.001) were independently associated with evolution into systemic sclerosis (SSc) in patients satisfying Kasukawa criteria at disease onset. The presence of the following autoantibodies at MCTD diagnosis was associated with specific organ involvement or clinical features in 2008: anti-Sm with renal involvement (p=0.004), anti-SSA/ro with neurological (p=0.014) and pulmonary involvement (p=0.010), anti-Scl70 with esophageal hypomotility or dilatation (p=0.048), anti-centromere with sclerodactyly (p=0.019), anti-dsDNA (0.009) and anti-SSA/ro (p=0.001) with serositis. Conclusions: A careful analysis of clinical and serological features at MCTD onset can help the physician in predicting disease evolution. Autoantibodies may be a potential predictor for the development of severe complications. Disclosure of Interest: None DeclaredCitation: Annals of the Rheumatic Diseases, volume 70, supplement 3, year 2011, page 666Session: Scleroderma, Myositis and related syndromes (Poster Presentations )