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Progrediente Luftnot und Schwäche bei einer 61-jährigen Patientin

Progressive respiratory failure and weakness in a 61-year-old woman

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Zusammenfassung

Eine 61-jährige Patientin wurde mit Verdacht auf eine atypische Pneumonie eingewiesen. Die weiterführende Diagnostik zeigte eine interstitielle Lungenerkrankung (ILD), Polyserositis, Polyarthritis sowie Myopathie. Durch Nachweis eines Anti-Threonyl-Transfer-RNA-Synthetase(PL-7)-Antikörpers konnte die Diagnose eines Antisynthetasesyndroms (ASS) gestellt werden. ASS sind seltene autoimmune Myopathien, die sich häufig als Multisystemerkrankung mit schwerer Beteiligung innerer Organe präsentieren. Unter einer Therapie mit Steroiden und Cyclophosphamid kam es zu einer erfolgreichen Remissionsinduktion. Eine Erhaltungstherapie mit Azathioprin ist geplant. ASS sollten in der Differenzialdiagnose von myopathischen Beschwerden und ILD stets bedacht werden.

Abstract

A 61-year-old woman was admitted with a suspected diagnosis of atypical pneumonia. Extended diagnostic measures revealed interstitial lung disease (ILD), polyserositis, polyarthritis and myopathy. With detection of an antibody against PL-7 (anti-threonyl-transfer-RNA synthetase) the diagnosis of anti-synthetase syndrome (ASS) was established. ASS are rare inflammatory myopathies which frequently present as multisystemic diseases with severe organ involvement. An immunosuppressive regimen with steroids and cyclophosphamide led to successful induction of disease remission. Maintenance therapy will be conducted with azathioprine. ASS should always be considered in the differential diagnosis of myopathies and ILDs.

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Authors and Affiliations

  1. III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    M. Mahmud, U. Schnoor & O. M. Steinmetz

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  1. M. Mahmud
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  2. U. Schnoor
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  3. O. M. Steinmetz
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Correspondence to M. Mahmud.

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M. Mahmud, U. Schnoor und O.M. Steinmetz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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H. Haller, Hannover (Schriftleitung)

B. Salzberger, Regensburg

C.C. Sieber, Nürnberg

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Mahmud, M., Schnoor, U. & Steinmetz, O.M. Progrediente Luftnot und Schwäche bei einer 61-jährigen Patientin. Internist 60, 186–192 (2019). https://doi.org/10.1007/s00108-018-0490-6

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  • DOI: https://doi.org/10.1007/s00108-018-0490-6

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