AUTOIMMUNE SCLERITIS RISK IN PERUVIAN ABORIGINES QUECHUAS WITH RHEUMATOID ARTHRITIS

Background: Autoimmune Scleritis is an extraarticular manifestations of severe rheumatoid arthritis, occur during the course of the disease and more rarely is the initial sign of the disease. This complication is usually a chronic disease that can be extremely painful and can lead to vision-threatening. There is a 1.2% prevalence of rheumatoid arthritis in a population of Peruvian Quechua ancestors and scleritis is not an uncommon manifestation. Objectives: Determine the risk of autoimmune scleritis in a population of Peruvian Quechua ancestors with rheumatoidarthritis. Methods: It was performed a cohort study in people with rheumatoid arthritis (RA) followed in therheumatology office at the Hospital III, Healthcare Network Juliaca, Puno, Perú; compared to those assessed in the ophthalmology office without history of autoimmune diseases,from January 2013 to December 2014. Statistical analysis was performed comparing proportions, analysis of man-hours anddetermining incidence rates. Results: Five cases were determined within 199 patients in the cohort of patients with RA, and seven cases were determined within the control group of 2592 patients: 3 patients withoutsystemic manifestations, one in relation to antibody anti-proteinase, 3 (ANCA-C), one withankylosing spondylitis and 4 classified as nonspecific oligoarthritis. The OR of scleritis in theAR group was 9.54; the incidence of scleritis was 8.42x1000 people. All patients were treated with topical and systemic corticosteroids. Two patients with RA had recurrence;one received cyclophosphamide 500 mg IV every 2 weeks presenting remission. Every case of scleritis and AR had anti-cyclic citrullinated peptide positive and only 4 patients hadpositive rheumatoid factor with high titles. Conclusions: Autoimmune scleritis is a severe complication of RA. This is the first study in a majority population of Quechua and mestizo ethnic groups; inhabitants of highlands. Causality is indisputable, associated with elevated antibodies; it is a further severe complication or form ofpresentation of RA; this justifies the creation of strategies for timely care. References: 1. Artifoni M, Rothschild P, Brézin A, Guillevin L, and Puéchal X. Associated With Ocular inflammatory diseases rheumatoid arthritis. Nat. Rev. Rheumatol. 2014; (10): 108-116. 2. Smith J, Mackensen F, J. Rosenbaum Therapy Insight: scleritis and Its relationship to systemic autoimmune disease. Nature Clinical Practice Rheumatology 2007; 3 (4): 219-26. 3. Hero E, Gutzwiller-Fontaine M, Scleritis and episcleritis T. Bourcier: diagnosis and treatment. Rev Med Interne. 2014 Sep; 35 (9): 577-85. 4. J. Sims Scleritis: presentations, disease associations and management. Postgrad Med J. 2012; 88 (1046): 713-8. 5. JM Sousa, Trevisani VF, Modolo RP, Gabriel LA, LA Vieira Freitas Dd. Comparative study of ophthalmological and serological manifestations and the therapeutic response of patients with isolated scleritis and scleritis Associated With systemic diseases. Arq Bras Oftalmol. 2011; 74 (6): 405-9. Acknowledgements: To Eva, Natalia and Tatiana from Reumacenter, Juliaca, Perú. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2015-eular.3009Citation: Annals of the Rheumatic Diseases, volume 74, supplement 2, year 2015, page 1019Session: Rheumatoid arthritis - comorbidity and clinical aspects (Abstracts Accepted for Publication )