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Background:A role for Epstein Barr Virus (EBV) infection in Systemic Lupus Erythematosus (SLE) pathogenesis is highly suspected. The frequency of EBV seroprevalence and DNA detection in peripheral blood mononuclear cells are increased in SLE patients compared to healthy controls.Objectives:To analyse the relationship between EBV blood replication and SLE disease activity.Methods:Monocentric, observational and retrospective study of SLE patients (ACR or SLICC criteria) who have had a blood EBV DNA assessment using Polymerase Chain Reaction (artus® EBV Virus QS-RGQ assay) between 2012 and 2018. Exclusion criteria were: organ or bone marrow transplant, absence of EBV seroconversion and insufficient data. SLE clinical features, the Safety of Estrogens in Lupus Erythematosus National Assessment–Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) flare index (SFI) and therapeutic regimen on the day of EBV DNA load assessment were recorded. A SELENA-SLEDAI score > 4 defined an active SLE. A blood EBV DNA load ≥125 IU/mL was defined as elevated.Results:A total of 105 patients (98 women and 7 men) were included in the study. At inclusion, median (quartiles) age and SLE duration were 34 (23.5-43) and 7 (2-14) years old, respectively. Treatment were hydroxychloroquine (HCQ) (n = 67; 64%), prednisone (n = 66; 63%) with an average (±Standard Deviation) dose of 11.3 (±16) mg/day and an immunosuppressant (n = 42; 40%). According to SFI, 57 SLE patients were experiencing a flare at the time of EBV assessment; flares were classified as severe and mild/moderate in 38 (36%) and 19 (18%) SLE patients, respectively. According to the SELENA-SLEDAI score, 60 patients (57%) were deemed active and 45 (43%) inactive. Main clinical manifestations were arthritis in 32 (30%) patients, constitutional symptoms (fever, weight loss, anorexia or lymphadenopathy) in 31 (30%), cutaneous involvement in 23 (22%), glomerulonephritis in 19 (18%), cytopenia in 14 (13%), neuropsychiatric involvement in 13 (12%) and serositis in 10 (16%). Blood EBV DNA was elevated in 54 (90%) of the 60 patients with active lupus versus 6 (13%) of the 45 patients with inactive SLE (p <10-4). It was increased in 34 (89%) of the 38 patients with severe flare, in 17 (89%) of the 19 patients with a mild/moderate flare (p = 1) and in 8 (17%) of the 48 patients without flare (p <10-4 vs severe flare and p <10-4 vs mild/moderate flare). EBV DNA load correlated with SELENA-SLEDAI score (r=0.58; p<0.0001). Elevated blood EBV DNA was not associated with HCQ, prednisone or immunosuppressant intakes. Eighteen patients with active SLE had a second assessment of blood EBV DNA load. For these patients, the median [range] of viral load was significantly higher during periods of active SLE (236 [0-2680] IU/mL) compared with periods with lower SELENA-SLEDAI score (0 [0-1537] IU/mL, p<10-4 in paired analysis).Conclusion:Blood EBV viral load is dramatically increased in active phase of SLE, independently of the treatment. We were unable to demonstrate whether the replication of EBV was the cause or the consequence or just an epiphenomenon of the disease activity. Further studies are needed to study whether EBV viral load is linked with Interferons secretion or B lymphocyte activation.Disclosure of Interests:None declared

BackgroundCoronary artery disease (CAD) is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE) patients.1 Whether SLE is a cardiovascular risk factor per se remains controversial.ObjectivesThis study was conducted to determine the clinical and angiographic characteristics of SLE patients with CAD and to compare them to those of control non-SLE patients with CAD.MethodsAll SLE patients who underwent a coronary angiography procedure in our tertiary centre between 2005 and 2016 were enrolled in the study. Those without significant atherosclerosis (stenosis >50%) were excluded. Each SLE patient was matched by sex and age at catheterization with seven non-SLE controls with significant CAD. Angiographic characteristics were reviewed by two independent cardiologists.ResultsAmong the 73 SLE patients who underwent coronary angiography, 28 patients had at least one significant coronary atherosclerotic lesion. The SLE patients were predominantly female (75%, median age of 55.7 years) with a long-standing disease duration (median SLE duration of 20.5 years). Ten patients (35%) had renal involvement, and 9 patients (32%) had antiphospholipid syndrome. The patients with SLE had fewer cardiovascular risk factors (1.6 vs 2.1, p=0.01) than the controls, including lower body mass index (23.8 kg/m² vs 24.98 kg/m², p=0.03), less frequent family history of coronary artery disease (3.5% vs 18%, p=0.049) and less diabetes (7% vs 22%, p=0.07) than controls. However, SLE patients were more likely to have chronic kidney failure (35% vs 20%, p=0.07) and to need hemodialysis (17% vs 2%, p=0.001). The SLE patients more often had multivessel disease (50%).ConclusionsWhile they have fewer cardiovascular risk factors, patients with SLE experience more severe CAD than non-SLE patients, suggesting that SLE, associated conditions or the treatments themselves play key roles in the development of atherosclerosis.2 References[1] Lee YH, Choi SJ, Ji JD, Song GG. Overall and cause-specific mortality in systemic lupus erythematosus: an updated meta-analysis. Lupus2016Jun;25(7):727–734.[2] Schoenfeld SR, Kasturi S, Costenbader KH. The epidemiology of atherosclerotic cardiovascular disease among patients with SLE: a systematic review. Semin Arthritis Rheum2013Aug;43(1):77–95.Disclosure of InterestNone declared

BackgroundCerebral venous thrombosis (CVT), which includes cerebral vein and dural sinus thrombosis, is a rare disorder that can lead to significant morbidity and mortality. Its occurrence in SLE in the absence of APS has been rarely reported. In this study we aimed to describe a cohort of SLE patients suffering from CVT without APS.MethodsWe collected retrospectively clinical and biological data of patients with confirmed CVT in the Pitié-Salpêtrière cohort of SLE (n=1352 patients). Patients fulfilled ACR SLE criteria. The diagnosis of CVT was confirmed by brain imaging studies. Exclusion criteria were patient with a lupus anticoagulant or IgG/IgM anticardiolipin antibodies or anti-β2 glycoprotein-1 abs. We searched on PUBMED database for case report of this association published in English until 31 August 2017. Lupus flares were defined according the SELENA Flare instrument.ResultsWe included 10 patients (8 women and 2 men). The median (range) age at diagnosis of CVT was 28 years.9–53 The CVT occurred with a median delay of 4 years (0–11) after the diagnosis of SLE. At the time of the CVT diagnosis: no patients had a past medical history of thrombotic event or miscarriage or foetal loss; 7 patients had a lupus flare (5 lupus nephritis [1 class I, 1 class V, 2 class IV and 1 class III+V], 4 immune thrombocytopenia, 2 autoimmune hemolytic anaemia, 3 cutaneous lupus, 1 serositis and 1 arthritis); 7 patients were treated with corticosteroids, 4 with hydroxychloroquine and 4 with immunosuppressive drugs. Other potential precipiting factors of CVT were: 2 nephrotic syndromes, 2 anaemia and 1 hyperhomocysteinemia. CVT was symptomatic for 9 patients: 8 headaches, 3 epilepsia and 1 sensitivo-motor deficit. The diagnosis of CVT was confirmed by magnetic resonance imaging (MRI) for 9 patients and cerebral angiography for 1 patient. The median delay between the onset of clinical symptoms and the diagnosis of thrombosis was 10 days.3–37 Nine patients presented a single localisation of CVT (superior longitudinal or lateral or cavernous sinus, or cortical cerebral vein). Only 1 patient had thrombosis of both lateral and sigmoid sinus. Cerebral infarction or haemorrhage was seen for 2 patients. Corticosteroids and immunosuppressant treatment were increased or introduced because of a concomitant lupus flare for 2 patients. All patients were treated with heparin followed by vitamin K antagonists for 7 patients or apixaban for 2 patients. One patient received long-term heparin. After a median survey of 19.5 (1–120) months: anti-coagulant drugs were stopped for 6 patients; recanalisations were complete in 7 of the 7 patients assessed on brain MRI; no patient had a residual neurological damage; only 1 patient had a new vascular event in the form of a brain haemorrhage. In addition to these 10 cases we found 17 cases from a literature review.ConclusionsCVT is a rare event in SLE in absence of APS. In our cohort SLE was often active at the time of the CVT occurrence. Most of the CVT were limited in extension and severity. The outcome on anticoagulant treatment was favourable without residual neurological damage. The occurrence of CVT in SLE is not an indication by itself to increase or to introduce corticosteroids or immunosuppressive drug.Disclosure of InterestNone declared

BackgroundTherapeutic adherence is a key element of chronic disease management and one of the most difficult to assess. The Belief about Medicines Questionnaire (BMQ) evaluates patients‘ own beliefs related to medication. It is available in two sections: the BMQ-General and the BMQ-Specific. The BMQ-specific focuses on the representations of medication prescribed for personal use. It was set up as a screening test for poor therapeutic adherence during certain chronic diseases. Early detection of lupus patients at risk of poor therapeutic adherence could lead to preventive actions.ObjectivesTo assess the BMQ-Specific as a predictive test of adherence to hydroxychloroquine in SLE.MethodsCase-control, retrospective and monocentric study. Cases were enrolled according to the following criteria: systemic lupus erythematosus (SLE) according to the ACR classification criteria and HCQ dosage <100 ng/ml after a minimum of 2 months of treatment. The matched control was a lupus patient, enlisted within the centre the same week, with a HCQ dosage ≥800 ng/ml. Each patient answered the BMQ-Specific through a telephone interview. The BMQ-Specific comprises two 5-item factors assessing beliefs about the necessity of prescribed medication (Specific-Necessity) and concerns about the danger of dependence and long-term toxicity of medication (Specific-Concerns). Responses to each statement were scored on a five-point Likert scale (1=strongly disagree and 5=strongly agree). Scores obtained for the individual items within both scales were summed to give total scores for the Specific-Necessity and Concerns scales range from 5 to 25. A Necessity–Concerns (N-C) differential was calculated (range from −20 to +20). It expresses the cost–benefit perceived by the patient for taking the medication. Case and control characteristics were compared using usual tests. Diagnosis performance of each BMQ score and necessity-concern differential were studied by the mean of ROC curves.ResultsThe BMQ-Specific questionnaire was submitted to 118 patients: 59 cases and 59 matched controls. The concern score was significantly higher in cases (mean 16.8 vs. 12.7, p<0.0001). The necessity score was significantly higher in control (mean 18.4 vs 15, respectively, p<0.0004). ROC curves show a better area under the curve (AUC) with the N-C differential compared to the AUC of separate scores (respectively 0,8 vs 0,7). The sensitivity and specificity are optimal for a N-C differential of 3.ConclusionsDuring SLE, nonadherent patients are primarily concerned about the risks inherent to treatment, rather than its effectiveness. To date, we are the only study to show that specific BMQ is an efficient tool for detecting patients at risk of poor therapeutic adherence to HCQ during SLE. The necessity-concerns differential score must be preferred to the scores taken separately. Thus, targeted educational actions can be provided as soon as the patients are taken in charge, in order to improve their adherence to treatment.Disclosure of InterestNone declared

Systemic lupus erythematosus (SLE) and small-sized vessel vasculitis are usually two distinguishable autoimmune diseases. However, a vasculitis may be found in the course SLE but rarely corresponds to an ANCA-associated vasculitis (AAV). We report four cases of de novo SLE associated with AAV, our aim being to discuss the clinical significance of this association. We included four patients fulfilling the criteria for both SLE and AAV and followed in two different university hospitals between 1996 and 2009. In light of a 20-year literature review (25 described clinical cases), we discussed the etiopathogeny of such an association. All patients presented a severe renal involvement (creatininemia ranging from 120 to 370 μmol/l) and thrombopenia (ranging from 45,000 to 137,000 platelets/mm 3 ). The other main clinical symptoms were arthritis ( n  = 3), serositis ( n  = 2) and intra-alveolar hemorrhage ( n  = 2). An inflammatory syndrome was noticed at diagnosis in all cases. ANCAs were MPO-ANCAs in all cases. Two out of these four patients were also diagnosed with antiphospholipid syndrome. The frequency of this association seems not fortuitous. Although the etiopathogenic mechanisms of such an association remain to be more precisely described, several clinical, histological and immunological features support the hypothesis of the existence of a SLE-AAV overlapping syndrome. Moreover, clinicians must be aware of such an overlapping syndrome, notably because its initial presentation can be very severe.

BackgroundPoor adherence to medication regimens is a major cause of relapse during systemic lupus erythematosus (SLE). Hydroxychloroquine (HCQ), the main therapy of SLE, has a long half-life. Thus, undetectable blood HCQ concentrations can be used to identify patients who do not take their treatmentObjectivesTo identify the determinants of poor therapeutic adhesion in patients with SLE.MethodsCase-control, retrospective, monocentric study. The cases were enrolled in our centre from 02/11/2011 to 13/01/2015 according to the following criteria: SLE defined according to ACR classification criteria and blood concentration of HCQ <100 ng/ml after a minimum of 2 months on therapy. For each case, the matched control was a lupus patient, enlisted from our centre the same week, with an HCQ dose greater than or equal to 800 ng/ml. Case and control characteristics were compared using standard tests and a uni-multivariate logistic regression.ResultsOne hundred and fifty patients were included, 75 cases (68 women) and 75 controls (72 women), with an average age of 35.7 years (±11.3 years) vs 35.6 years (±10.6 years). Most patients had inactive lupus (3 patients had SLEDAI ≥4), 27% of them had benefited from therapeutic education sessions. The average dosage of HCQ was 1110 ng/ml within the control group. In our univariate analysis, nonadherent patients lived significantly further away from the centre than adherent patients (median distance [interquartile range]: 2211–52 vs 14 km [5.9–35], respectively, p=0.03) and were more likely to be unemployed, (23 vs 8%, respectively, p=0.006). Nonadherent patients had less often benefited from the patient‘s therapeutic education program (18 vs 35%, respectively, p=0.018), were taking less treatment (3 vs 4, respectively, p=0.008), had a significantly lower level of education (61% compared to 89% of patients with at least a bachelor’s degree, p<0.001). In our multivariate analysis, a level of education below the A levels was the strongest factor explaining poor therapeutic adherence, OR (IC 95): 4.09 (1.5–10.8).ConclusionsThe main drivers of therapeutic adherence during SLE are socio-economic factors. The least educated and most disadvantaged patients are most likely to display poor therapeutic adherence. Targeted preventive actions and enhanced therapeutic education should be provided to them.Disclosure of InterestNone declared

BackgroundRenal biopsy is the cornerstone of Lupus nephritis (LN) management. However, transcutaneous renal biopsy (TCRB) is hampered by the antithrombotic treatment frequently prescribed in Systemic Lupus Erythematosus (SLE) and Antiphospholipid Antibody Syndrome (APS). Transjugular renal biopsy (TJRB) offers an attractive alternative for patients at increased risk of bleeding.ObjectivesThe primary objective of the study was to describe the safety and the diagnostic performance of TJRB in SLE and APS.MethodsA retrospective review of SLE and/or APS patients who consecutively underwent a renal biopsy in our department between January 2004 and October 2016 was performed. Biopsies were divided into four groups: TCRB, TJRB with aspirin treatment (aspirin TJRB), TJRB with anticoagulant treatment (anticoagulant TJRB), and TJRB without anti-thrombotic drug (no-antithrombotic TJRB). Major complications were defined as decease, haemostasis nephrectomy, renal artery embolization, blood transfusion, sepsis and vascular thrombosis. Minor complications were defined as gross haematuria, renal hematoma and arterio-venous fistula.ResultsFifty-four TCRB and 256 TJRB were analysed – 69 aspirin TJRB, 68 anticoagulant TJRB and 119 no-antithrombotic TJRB. Major complications rate was 1.9% for TCRB and 2.0% for TJRB (p=1). One patient in the TJRB group suffering from catastrophic antiphospholipid syndrome (CAPS) died suddenly 6 weeks after the biopsy. No patient died of bleeding complication. One patient in the anticoagulant TJRB group required a renal artery embolization and blood transfusion. Four other patients required blood transfusion (1 in the TCRB group, 1 in the aspirin TJRB group and 2 in the anticoagulant TJRB group). Minor complications rate was 1.9% for TCRB and 7.8% for TJRB (p=0.2).Among the 256 TJRB, the rate of complication (major or minor) was higher for patients with glomerular filtration rate CKD-EPI <30 mL/min (6/24 [25%]) compared to patients with GFR >30 mL/min (16/232 [7%], p<0.01 using the Khi-2 test). Age over 40, blood pressure >140/90 mmHg, APS or positive antiphospholipid biology without APS, Prothrombin Time<50%, activated Partial Thromboplastin Time ratio >1.2, platelets<50 G/L and biopsied kidney size were not associated with a higher rate of complications.The number of glomeruli sampled and the performance of the biopsy to establish a histologic diagnostic were similar in the 4 groups.ConclusionsTJRB provides diagnostic yield and safety similar to those of TCRB. It should be considered as a first intention procedure for SLE and APS patients at risk of bleeding.Disclosure of InterestNone declared

BackgroundThe occurrence of a TMA during SLE is a rare event that complicates 1% to 4% of lupus. The full spectrum of TMA can be encountered in the course of SLE: acquired thrombotic thrombocytopenic purpura (PTT), TMA associated with glomerulonephritis (TMA GN), atypical hemolytic uremic syndrome (aHUS), microangiopathic antiphospholipid syndrome (MAPS; defined or probable catastrophic antiphospholipid syndrome) or HELLP syndrome during pregnancy.ObjectivesTo describe the clinical phenotype of TMA in lupus, to specify the prognosis and to identify factors allowing early classification and management of the different subtypes.MethodsWe performed a French multicentric retrospective study from January 1987 to December 2017 in units of internal medicine, nephrology and ICU. Inclusion criteria associated SLE defined by the ACR and/or SLICC criteria and a TMA defined either by the presence of microangiopathic anaemia and peripheral thrombocytopenia, either by histological signs of TMA.Results68 events of TMA occurred in 60 SLE patients; median age was 24 years; 56 women (F/M ratio: 14). Diagnosis of SLE was assessed at a paediatric age in 24 (35.8%) patients. Clinical manifestations of SLE were: acute cutaneous lupus (n=48, 71%), arthritis (n=36, 53%), pleuritis (n=13, 19%), pericarditis (n=25, 37%), renal involvement (n=39, 57% including 20 class IV glomerulonephritis) and auto-immune cytopenia (n=22, 32%). Triggering factors of TMA were: lupus flare (n=38), infections (n=12), pregnancy and peripartum (n=3), or therapeutic rupture (n=4). Clinical and biological features at diagnosis of each subtypes of TMA are presented in table 1. A platelet count lower than 28 000/mm3 was predictive of TTP diagnosis (Se=90,5%, Sp=88,5%), likewise a creatinine plasma level greater than 100 µmol/L was predictive of TMA GN (Se=88,5%, Sp=85%). The treatment of TMA included (alone or in combination): corticosteroids in all cases, plasma exchange (n=52), cyclophosphamide (n=28), Rituximab (n=15), Eculizumab (n=2), antiplatelet agent (n=36), and/or effective anticoagulation (n=26). The median duration of follow-up was 150 months. Among TMA GN patients, the final median GFR was 58 mL/min (range: 0–120) with 5 individuals on chronic dialysis and 1 kidney transplant. Among TTP patients, one died from TMA, whereas the final median GFR of survivors (n=59) was 97 mL/min (range: 64–150), without any patient requiring dialysis.Table 1 Comparisons of clinical and laboratory data in different subtypes of TMA in SLEConclusionsSLE-associated TMA is a heterogeneous syndrome. TTP with a decreased ADAMTS13 activity and a low platelets level (<28000/mm3) have a good renal prognosis, whereas TMA GN with a high creatinine level (>100 µmol/L) have a poor renal prognosis. Early subtypes classification is mandatory for the clinician to provide prompt and appropriate management of this life-threatening complication.Disclosure of InterestNone declared

BackgroundOutcome of juvenile-onset SLE (j-SLE) during adulthood is poorly described.ObjectivesTo report adult outcome of j-SLE and compare SLE course during childhood and adulthood.Methodsj-SLE was defined as a SLE fulfilling ACR criteria and diagnosed before the age of 16 years. Mac Nemar test for paired nominal data and Wilcoxon signed rank test for paired data were used.ResultsOne hundred and six patients j-SLE (88 women and 18 men, female to male ratio: 4.9), mean age at diagnosis: 12.3 years were followed during a mean duration of 13.8 years, from childhood (mean: 4 years) to adulthood (mean: 10.3 years). 97.2% patients received corticosteroids (with intravenous pulses for 50.9%) and 77.3% immunosuppressant drugs. 105 (99%) patients received antimalarial drugs.Clinical manifestations of the first flare were: arthritis (67.9%), cutaneous (57.5%), nephritis (23.6%), fever (17.9%), hematologic: ITP, AIHA (15%). Neuropsychiatric manifestations were found in 6.6%. Digestive involvement was only present in 6% of cases. According to the revised SELENA FLARE INDEX (SFI), the first flare was severe for half of the patients (n=55).Disease course during adulthood had two patterns: 82 patients (77.3%) had at least one SLE flare and 24 (22.6%) a sustained remission. Mean follow up was however significantly higher in the relapsing group (15 years vs 9.8 years, p=0.0014). No difference was found between these 2 groups for first flare severity and clinical manifestations during childhood.Significantly more cutaneous (61.3 vs 42.4%, p=0.003), musculoskeletal (75.5 vs 59.4%, p=0.007), neuropsychiatric (10.4 vs 3.8%, p=0.035), or hematologic manifestations like AIHA (9.4 vs 2.8%, p=0.039) or ITP (26.4 vs 10.4%, p=0.001), and fever (32.1 vs 3.7%, p<0,001) were observed during childhood than during adulthood. Nephritis occurred at similar frequencies in childhood and adulthood (34.9% and 30.2% respectively). Half of adulthood nephritis were relapses of j-SLE nephritis.At the end of the survey mean global SLICC damage index (SDI) was 0.64. Mean childhood SDI was lower than mean adulthood SDI (0.21 vs 0.45, p=0.016). However mean adult follow up was significantly longer. Mean SDI increase per year was similar during childhood and adulthood (0.053 vs 0.049 respectively, p=0.563).13 patients (12.3%), had musculoskeletal damage occurring more frequently during adulthood than childhood (11 vs 2, p=0.022), specially avascular necrosis (8 vs 0, p=0.008). 5 (4.7%) patients had a renal damage that occurred mostly during adulthood (n=4). Ocular damage was present for 9 (8.5%) patients. Premature gonadal failure occurred for 5 women (5.7%). Among the 88 women 19 had 32 pregnancies, leading to 22 births.ConclusionsDamage accrual seems to increase at the same pace during childhood and adulthood. SDI was low at the end of the survey. This could reflect a protective role for HCQ, more immunosuppressant use with lower dose of steroids. Juvenile SLE nephritis are at high risk of relapsing during adulthood raising the issue of duration of immunosuppressive treatment.Disclosure of InterestNone declared

BackgroundPatients with systemic lupus erythematosus (SLE) are at higher risk than the general population of developing lymphoma. Relatively little is known about the risk factors, the treatment and the outcome of lymphoma in SLE.ObjectivesWe aimed to describe a cohort of patients suffering from lymphoma in the setting of SLE and to study the risk factors of developing this complication.MethodsWe collected clinical data of SLE patients with confirmed lymphoma in a multicentric and retrospective study. SLE patients were eligible for the study if they fulfilled at least 4 of the 1997 ACR criteria for SLE. Exclusion criteria were HIV or C hepatitis infection.ResultsWe included 38 patients (34 women and 4 men) coming from 10 different French University Hospitals. The lymphoma occurred after the diagnosis of SLE for 35 patients, with a median (range) time of 8.8 years (0–39). In their past or present medical history, 11 (29%) had a haematological involvement (5 immune thrombocytopenias, 4 autoimmune hemolytic anemias and 2 patients with both). Nine patients (24%) had associated Sjögren syndrome. 22 patients (58%) had a polyclonal hypergammaglobulinemia. Before the occurrence of the lymphoma, 18 patients (47%) had received an immunosuppressant during a median (range) period of 67 months.6–195 17 patients had an indolent B cell lymphoma (IBCL), 14 a high-grade B cell lymphoma (11 diffuse large B cell lymphoma [DLBCL]; 2 a primary DLBCL of the central nervous system; and 1 an iatrogenic immunodeficiency-associated lymphoproliferative disorder), 5 a Hodgkin’s disease (HD), and 2 a T cell lymphoma. The EBER in situ hybridization stain was positive in 7 of the 13 patients assessed (3/3 HD, 3/7 DLBCL and 1/2 IL) and was not associated with the immunosuppressant prescription. The median (range) of the survey after the lymphoma was 28.5 month (0–235.1). The 14 DLBCL patients except 1 were treated with chemotherapy: 4 died, 9 were in complete remission and 1 was in progression. Regarding the 17 IBCL, 9 patients were treated with chemotherapy, 2 patients with surgery, 1 patient with radiotherapy and 5 patients were not treated: 3 patients had to short follow-up or were lost, 1 died, 2 developed a DLBCL, 4 were stable and 7 were in complete remission. The 5 HL were treated with chemotherapy and all were in complete remission.ConclusionsIBCL and DLBCL were the most common type of lymphomas in SLE patients. Data suggest a role for EBV but not for exposition to immunosuppressant in the pathogenesis of SLE-associated lymphoma. The outcome of lymphoma in the setting of SLE seems not different from the outcome of lymphoma in the general population. A case-control study is ongoing to study the risk factors associated with the occurrence of lymphoma in SLEDisclosure of InterestNone declared