AB1129 Epidemiological and clinical profile of patients with paraneoplastic rheumatologic syndromes in a spanish tertiary hospital
Authors: A. Briones-Figueroa, W.A. Sifuentes-Giraldo
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Paraneoplastic rheumatic syndromes (PRS) are defined as rheumatic symptoms caused by a malignancy, but which are not caused directly by the tumour or metastasis. PRS are characterised by a close temporal relationship with an underlying malignancy and fast regression of the symptoms after the treatment of the primary tumour. <h3>Objectives</h3> To describe the epidemiological and clinical profile of patients diagnosed with PRS in a Spanish tertiary hospital. <h3>Methods</h3> A retrospective observational study was performed, which included all patients who were diagnosed of PRS in our centre during the period 1985–2017. The demographic, clinical and outcome data were obtained from their medical records. <h3>Results</h3> During the study period 48 patients with suspected paraneoplastic syndrome were identified, but diagnosis was confirmed in 14 of them, 7 women (50%), with a mean age at diagnosis of 69.8±14.5 years. 42,9% of patients were smokers, 14,3% reported alcohol consumption, 35,7% and 7,1% had personal and family history of neoplasia, respectively; no patient reported personal or family history of autoimmune disease. The comparison between patients with and without PRS is shown in the table, but no significant differences were identified. The most common neoplasm was breast cancer (28.6%). 21,4% of the cases of PRS appeared as a consequence of a tumour recurrence. In 42.9% of patients the diagnostic of the tumour was concomitant to PRS, while the remaining 57.1% SPR was previous. The most frequent paraneoplastic syndrome was polymyalgia rheumatica (42.9%), followed by dermatomyositis(28.6%) and paraneoplastic polyarthritis (28.6%). The most common musculoskeletal manifestation was shoulder girdle pain and stiffness (35.7%) followed by polyarthritis and proximal muscular weakness (28.5%). 85.7% of the patients had high erythrocyte sedimentation rate and C-reactive protein levels with a mean value of 60.2±39,4 mm/h and 77.6±9.5 mg/L, respectively. Antinuclear antibodies were positive in 7 patients (50%), while rheumatoid factor, anti-CPP and anti-RNP were positive in 1 patient each (7,1%). The response of PRS to the treatment of the tumour was available in 9 patients, of which 6 (66.7%) presented remission of the PRS. Regarding mortality, 5 patients (35.7%) died due to complications associated with the primary tumour. <h3>Conclusions</h3> Polymyalgia rheumatica was the most frequent PRS in our study, in contrast to several published series where other PRS are more common such as hypertrophic osteoarthropathy, polyarthritis and dermatomyositis/polymyositis. The laboratory data and response to treatment of the tumour were similar to those reported in the literature. The mortality in our series was high, but in none of the cases was related directly to PRS. <h3>Reference</h3> [1] Manger B, Schett G. Paraneoplastic syndromes in rheumatology. Nat Rev Rheumatol. 2014;10:662–70. <h3>Disclosure of Interest</h3> None declared