Anti-synthetase syndrome

Abstract

We report the case of a 39-year-old female who presented with breathlessness on exertion, cough, myalgias for the past 6 months and fever for 1 month. Chest X-ray revealed bilateral multilobar consolidation. High-resolution computed tomography (HRCT) of the chest revealed bilateral interstitial thickening, traction bronchiectasis and consolidation in the posterior segment of the left upper lobe. Laboratory investigations showed mild normocytic, normochromic anaemia (haemoglobin 10.4 g/dL), thrombocytosis (platelet count 6.03 lakhs/mm3), peripheral blood eosinophilia (11%) and raised erythrocyte sedimentation rate (100 mm at the end of the first hour). Serum creatine kinase (178 IU/L) was normal. Anti-nuclear antibody (ANA) tested positive and ANA profile revealed anti-Jo-1 antibodies. She was diagnosed to have anti-synthetase syndrome based on the above clinical features and positive autoantibodies. The present case highlights the importance of obtaining HRCT chest and ANA profile in confirming the diagnosis in patients with clinically suspected inflammatory muscle diseases and associated interstitial lung diseases. This case also brings to light the uncommon occurrence of anti-synthetase syndrome among idiopathic inflammatory muscle diseases.

Keywords

• anti jo-1 antibodies
• anti-synthetase syndrome
• idiopathic inflammatory muscle diseases