AB1022 PANNICULITIS IN RHEUMATOLOGICAL PRACTICE: THE RESULTS OF LONG-TERM FOLLOW-UP
Background:Panniculitis is a group of heterogeneous inflammatory diseases that occur with damage to the subcutaneous fat (SCF), musculoskeletal system, and often internal organsObjectives:to evaluate the course and outcome in patients with panniculitisMethods:the course of the disease was monitored in 193 patients treated at the V.A. Nasonova Research Institute of Rheumatology for 3-5 years (142 women, 51 men) aged 19 to 77 with the referral diagnosis of erythema nodosum (EN) and undifferentiated panniculitis and with the disease duration of 1 week to 13 years. In addition to general clinical study, serum concentrations of α-1 antitrypsin, amylase, lipase, ferritin, creatinephosphokinase were determined, computed tomography of the chest organs, immunological, ultrasound scanning of the skin and SCF of the node area, tuberculosis tests and pathomorphological study of skin biopsy from the node area were performed.Results:: as a result of laboratory and instrumental examination, the following diagnoses were made: EN associated with infection (72 people – group 1), lipodermatosclerosis (LDS) (40 –group 2), idiopathic lobular panniculitis (ILP) (32 – group 3), Löfgren’s syndrome (SL) (49 –group 4). During the follow-up period, 6 deaths occurred (3.1%): in a patient with LDS due to acute heart failure and in 5 patients with ILP due to the activity of the disease which led to the development of cardiopulmonary pathology and disseminated intravascular coagulation (DIC) syndrome. In group 1, during the observation period, UE recurred in 18 people (25%), the probable causes were: hypothermia (6), exacerbation of chronic tonsillitis (6), acute respiratory viral infections (ARVI) (4), stress (1), a rapid decrease in the dose of glucocorticoids (GC) (1), the cause is unknown (2). In group 2, recurrence occurred in 19 patients (47.5%) due to the lack of anti-inflammatory therapy (plaquenil) (10), trauma (4), stress (3), and weight lifting (2). There was no recurrence in 7 patients in this group, however, nodes would not disappear completely, which is obviously due to the absence of plaquenil. In group 3, recurrence was registered in 24 cases (75%) and it was associated with insufficient effect of the ongoing anti-inflammatory therapy (9), a decrease in blood glucose to minimal doses (6), hypothermia (6) and the absence/cancellation of anti-inflammatory therapy (3). In group 4, recurrence of nodes was registered in 14 cases (28.5%), possible causes: cancellation of GC (9) and cooling/ARVI(5).Conclusion:in the observed group of patients with panniculitis mortality was 3.1%. The main causes of recurrence in EN were viral-bacterial infections, and in case of ILP, LDS and SL it was insufficient effect/absence of anti-inflammatory therapy.Disclosure of Interests:None declared