i n d i a n j o u r n a l o f r h e uma t o l o g y 9 ( 2 0 1 4 ) S 7eS 6 7S36

Introduction: Studies shows, SLE patients are more prone to have

atherosclerosis and cardiovascular diseases than normal popu-

lation .Recent studies hypothesize that atherosclerosis has simi-

larities with other inflammatory and autoimmune diseases like

SLE.

Methods: Our study was designed to evaluate factors associated

with the development of atherosclerosis in patients with SLE. As a

surrogate measure of atherosclerosis we considered the CIMT

evaluated by B mode ultrasound. CIMT value of 0.7mm was

considered cut-off. Total 47 patients of SLEwere included in study.

SPSS (version 14) software program was used for analysis.

Result: Mean age was 28.1±7.3years.Increased age (<30yrs

vs>30yrs)was associated with raised CIMT (p <0.01) .The mean

disease duration of patients with raised and normal CIMT was

71.6±32.5 and 13.5±18.2 months respectively (p<0.01). Correlation

of SLEDAI score >10 and increased CIMT was significant (p<0.014).

According to NCEP criteria, 27 (57.44%) had dyslipidemia. Raised

CIMTwas in 13/27(48.1%) of dislipidaemic compared to 1/20 (5%) in

non-dislipidaemic patients (p<0. 01).Raised LDL cholesterol and

Triglycerides correlates with raised CIMT. Increased CIMT

correlates with increased BMI (BMI 23.5±2.8 Vs 25.9±2.2

kg/m2) (p<0.01).Raised CIMT was present in 60% hypertensive

as compared to 7.5% non-hypertensive patients (p<0.01). Hypo-

thyroidism was found in 7% patients, all were on thyroid supple-

ments. Raised CIMT was found in 87.5% hypothyroid patients

(p<0.01).Patients with higher CIMT were having higher mean cu-

mulative steroid intake of 16.6gms (p<0.01).

Conclusion: Age, longer disease duration, SLEDAI score >10, dys-

lipidaemia, higher BMI, hypertension, increased cumulative ste-

roid dosage and hypothyroidism are independent risk factors for

atherosclerosis in lupus patients.

P101. Seroprevelance of antiphospholipid antibody insystemic lupus erythematosus

Daisy Doleya, Sanjeeb Kakatia, Lahari Saikiab; aDepartments ofInternal Medicine and bMicrobiology, Assam Medical College,Dibrugarh, India

Introduction: Systemic Lupus Erythematosus (SLE) is associated

with significant morbidity and mortality. Anti-phospholipid

antibody positivity further increases these risks due to arterial

and/or venous thrombosis and recurrent pregnancy losses.

Methods: 70 SLE cases were taken up at a tertiary centre for

evaluation of the prevalence of Anti-Phospolipid Antibodies

(APLA): anticardiolipin antibody and lupus anticoagulant. The

presence of APLA was correlated with the clinical features of SLE.

Anticardiolipin (aCL) IgM and IgG antibody were detected by ELISA

and Lupus anticoagulant (LA) by DRVVT method.

Results: 30 cases (42%) had renal manifestations. ACL IgM was

found positive in 13 cases(18%), ACL IgG in 13 cases(18%).Both ACL

IgM and ACL IgGwas positive in 9 cases(12%). Lupus anticoagulant

was positive in 9 cases (12%).

In the lupus nephritis group, 8 cases (26%) were positive for either

IgM or IgG ACA. In the non-nephritis group, 9 cases (22%) were

positive for either IgM or IgG ACA. LA was positive in 5 cases (16%)

in the lupus nephritis group and 4 cases (10%) in the non-nephritis

group.

Conclusion: The prevalence of APLA was 28.6%. In this study both

ACA and LA positivity was found slightly higher in lupus nephritis

group. Prevalence of ALPA in SLE may be a marker of poorer

prognosis unless detected early and managed. This shows the

importance of screening of all SLE patients for APLA antibodies.

P102. Predictors of major infection in patients following majorimmunosuppressive therapy e An observational study

C. Srinivasa, I.R. Varaprasad, L. Rajasekhar.; Department ofRheumatology, Nizam's Institute of Medical Sciences, Hyderabad, India

Introduction: Rheumatic disease patients receiving immunosup-

pression frequently develop severe acute, chronic (tuberculosis),

and opportunistic infections.

Objective: To determine predictors of serious infection in 6

months following treatment with cyclophosphamide (CYC) and

pulse methylprednisolone (MP).

Methods: Inpatients records of patients admitted in 2013 who

received 3 gmMP andmonthly CYC over 6 months were screened.

SLE patients with no infections (SLEUI), with infections (SLEI) and

patients with other rheumatic diseases (ORD, primary vasculitis,

dermatomyositis) were compared. Age, SLEDAI, total leukocyte

count, renal failure and dsDNAwere noted in both SLEUI and SLEI

patients.

Results: Seventeen major infections were identified among 52

patients (43 SLE, 9 ORD) who received above treatment over 6

months. Mean duration to infection was 51 days. Four patients

had tuberculosis, 3 cellulitis, 2 UTI, 2 septicemia, 2 musculoskel-

etal infections and 1 had pneumonia. Fifteen (34.9%) SLE patients

developed infections compared to 2 (22.2%) ORD patients(P¼0.4).

Mean age, mean SLEDAI was similar in SLEI (16.5±5.9) and SLEUI

(18.07±7.9) (p¼0.3). No patient had diabetes or renal failure. 8 of 15

SLEI patients had leucopenia compared to 3 of 28 SLEUI patients

(p¼0.002). Infections resulted in 2 deaths both in SLE.

Conclusion: One third of patients receiving major immunosup-

pression developed infection. Incidence is higher in lupus than

other rheumatic diseases. Leucopenia at onset is an important

predictor of major infection in lupus. Guidelines on TB and bac-

terial prophylaxis are needed.

P103. Hypercalcemia e Lymphadenopathy Systemic LupusErythematosus(Hl-Sle)

Kaushik Rajamania, Kiran Putchakayalab; aUniversity HospitalWales; bLeighton Hospital, Crewe, UK

Introduction: SLE is a chronic autoimmune inflammatory disease.

Hypercalcemia in SLE is rare. We report a 25 year old lady with SLE

and hypercalcemia. She presented to A&E with complaints of

nausea, vomiting, abdominal pain and polyarthralgia. O/e BP 20/

70.Erythematous maculopapular rash on the dorsum of hands. B/L

axillary lymphadenopathy was present, non-tender and firm in

consistency. Chest clear, heart sounds normal. Urine dip normal.

Bloods.

WCC - 8.0 109/L; ANA/Ro/La - þve; IgG - 15.7g/L; Neutrophils - 7.2

109/L; dsDNA e 34; IgM - 0.97 g/L; Lymphocytes - 0.39 109/L; Sm/

RNP/DCT - þve; No paraproteins; ESR - 34mm/hr; Serum ACE

normal; Vitamin D - 33.6; Corrected calcium 3.33; C 3 - 0.61; C4 -

0.09; PTH - <0.3; Imaging; CXR:Normal; CT chest and abdomen/

pelvis: multiple significantly enlarged bilateral axillary lymph

nodes with b/l pleural effusion. Axillary lymph node biopsy:

lymph node showed follicular hyperplasia and sinus histiocytosis;

Bone marrow trephine: Normal; Treatment: With Prednisolone

and Hydroxychloroquine, her serum Ca/lymphocyte count

reverted to normal with regression in the size of the

lymphadenopathy.

Conclusion: SLE needs to be considered in patients with

hypercalcemia. It may be associated with pleuritis and