Skip to main content

Advertisement

Log in

Antisynthetase antibody syndrome: case report and review of the literature

  • Case Based Review
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Antisynthetase antibody syndrome is a rare autoimmune disease that may present with variable systemic manifestations, mainly polymyositis, interstitial lung disease, skin lesions, and Raynaud’s phenomenon. This diagnosis should always come to mind in patients that present with signs of myositis, dermatomyositis, or polymyositis associated with interstitial lung disease. On the following paper, we report the case of a 52-year-old man who presented with a 2-month history of asymmetric polyarthralgia, myalgia, weight loss of 8 kg, and progressive muscle weakness associated with dyspnea, orthopnea, and dysphonia. Further tests revealed myositis, interstitial pneumonia, and elevation of anti-Jo-1 antibodies. A diagnosis of antisynthetase antibody syndrome was made and the patient showed good response to treatment with corticoids and methotrexate. Finally, we present a short review of the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hochberg MC, Feldman D, Stevens MB, Arnett FC, Reichlin M (1984) Antibody to Jo-1 in polymyositis/dermatomyositis: association with interstitial pulmonary disease. J Rheumatol 11:663–665

    PubMed  CAS  Google Scholar 

  2. Love LA, Leff RL, Fraser DD, Targoff IN, Dalakas M, Plotz PH, Miller FW (1991) A new approach to the classification of idiopathic inflammatory myopathy: myositis-specific autoantibodies define useful homogeneous patient groups. Med (Baltimore) 70:360–374

    Article  CAS  Google Scholar 

  3. Berg JM, Tymoczko JL, Stryer L (2002) Biochemistry. 5th. W H Freeman, New York. Section 29.2, Aminoacyl-Transfer RNA Synthetases Read the Genetic Code. Available from http://www.ncbi.nlm.nih.gov/books/NBK22356/. Accessed August 2012

  4. Labirua-Iturburu A, Trallero Araguás E, Selva O’Callaghan A (2010) Síndrome por anticuerpos antisintetasa. Med Clin (Barc) 137(2):77–83

    Article  Google Scholar 

  5. Katzap E, Barilla-La Barca ML, Marder G (2011) Antisynthetase syndrome. Curr Rheumatol Rep 13:175–181

    Article  PubMed  CAS  Google Scholar 

  6. Targoff IN, Arnett FC (1990) Clinical manifestations in patients with antibody to PL-12 antigen (alanyl-tRNA synthetase). Am J Med 88:241–251

    Article  PubMed  CAS  Google Scholar 

  7. Richards TJ, Eggebeen A, Gibson K, Yousem S, Fuhrman C, Gochuico BR, Fertig N, Oddis CV, Kaminski N, Rosas IO, Ascherman DP (2009) Characterization and peripheral blood biomarker assessment of anti-Jo-1 antibody positive interstitial lung disease. Arthritis Rheum 60(7):2183–2192

    Article  PubMed  CAS  Google Scholar 

  8. Takada K, Nagasaka K, Miyasaka N (2005) Polymyositis/dermatomyositis and interstitial lung disease: a new therapeutic approach with T-cell-specific immunosuppressants. Autoinmunity 38(5):383–392

    Article  CAS  Google Scholar 

  9. Váncsa A, Csípo I, Németh J, Dévényi K, Gergely L, Dankó K (2009) Characteristics of interstitial lung disease in SS-A positive/Jo-1 positive inflammatory myopathy patients. Rheumatol Int 29(9):989–994

    Article  PubMed  Google Scholar 

  10. Kalluri M, Sahn SA, Oddis CV, Gharib SL, Christopher-Stine L, Danoff SK, Casciola-Rosen L, Hong G, Dellaripa PF, Highland KB (2009) Clinical profile of anti-PL-12 autoantibody cohort study and review of the literature. Chest 135:1550–1556

    Article  PubMed  CAS  Google Scholar 

  11. Schnabel A, Reuter M, Biederer J, Richter C, Gross WL (2003) Interstitial lung disease in polymyositis and dermatomyositis: clinical course and response to treatment. Semin Arthritis Rheum 32(5):273–284

    Article  PubMed  Google Scholar 

  12. Friedman AW, Targoff IN, Arnett FC (1996) Interstitial lung disease with autoantibodies against aminoacyl-tRNA synthetases in the absence of clinically apparent myositis. Semin Arthritis Reum 26:459–467

    Article  CAS  Google Scholar 

  13. Hervier B, Wallaert B, Hachulla E, Adoue D, Lauque D, Audrain M, Camara B, Fournie B, Couret B, Hatron PY, Dubucquoi S, Hamidou M (2010) Clinical manifestations of antisynthetase syndrome positive for antialanyl-tRNA synthetase (anti-PL12) antibodies: a retrospective study of 17 cases. Rheumatology 49:972–976

    Article  PubMed  CAS  Google Scholar 

  14. Stone KB, Oddis CV, Fertig N, Katsumata Y, Lucas M, Vogt M, Domsic R, Ascherman DP (2007) Anti-Jo-1 antibody levels correlate with disease activity in idiopathic inflammatory. Arthritis Rheum 56(9):3125–3131

    Article  PubMed  CAS  Google Scholar 

  15. Sato S, Hirakata M, Kuwana M, Nakamura K, Suwa A, Inada S, Mimori T, Ikeda Y (2005) Clinical characteristics of Japanese patients with anti-PL-7 (anti-threonyl-tRNA synthetase) autoantibodies. Clin Exp Rheumatol 23:609–615

    PubMed  CAS  Google Scholar 

  16. Targoff IN (2008) Antisynthetase syndrome. In: Schoenfeld Y, Cervera R, Gershwin ME (eds) Diagnostic criteria in autoimmune diseases. Humana, Totowa, pp 169–174

    Chapter  Google Scholar 

  17. Morgenthau AS, Padilla ML (2009) Spectrum of fibrosing diffuse parenchymal lung disease. Mt Sinai J Med 76(1):2–23

    Article  PubMed  Google Scholar 

  18. Schnabel A, Reuter M, Biederer J (2003) Interstitial lung disease in polymyositis and dermatomyositis: clinical course and response to treatment. Semin Arthritis Rheum 32(5):273–284

    Article  PubMed  Google Scholar 

  19. Targoff IN (2000) Update on myositis-specific and myositis-associated autoantibodies. Curr Opin Rheumatol 12(6):475–481

    Article  PubMed  CAS  Google Scholar 

  20. Jankowska M, Butto B, Debska-Slizień A, Rutkowski B (2007) Beneficial effect of treatment with cyclosporin A in a case of refractory antisynthetase syndrome. Rheumatol Int 27(8):775–780

    Article  PubMed  Google Scholar 

  21. Guglielmi S, Merz TM, Gugger M, Suter C, Nicod LP (2008) Acute respiratory distress syndrome secondary to antisynthetase syndrome is reversible with tacrolimus. Eur Respir J 31(1):213–217

    Article  PubMed  CAS  Google Scholar 

  22. Knoell KA, Hook M, Grice DP, Hendrix JD Jr (1999) Dermatomyositis associated with bronchiolitis obliterans organizing pneumonia (BOOP). JAm Acad Dermatol 40(2 Pt 2):328–30

    Article  CAS  Google Scholar 

  23. Douglas WW, Tazelaar HD, Hartman TE, Hartman RP, Decker PA, Schroeder DR, Ryu JH (2001) Polymyositis-dermatomyositis-associated interstitial lung disease. Am J Respir Crit Care Med 164(7):1182–1185

    Article  PubMed  CAS  Google Scholar 

  24. Hervier B, Masseau A, Mussini JM, Audrain M, Hamidou MA (2009) Long-term efficacy of mycophenolate mofetil in a case of refractory antisynthetase syndrome. Joint Bone Spine 76(5):575–576

    Article  PubMed  Google Scholar 

  25. Demedts M, Behr J, Buhl R, Costabel U, Dekhuijzen R, Jansen HM, MacNee W, Thomeer M, Wallaert B, Laurent F, Nicholson AG, Verbeken EK, Verschakelen J, Flower CD, Capron F, Petruzzelli S, De Vuyst P, van den Bosch JM, Rodriguez-Becerra E, Corvasce G, Lankhorst I, Sardina M, Montanari M, IFIGENIA Study Group (2005) High dose acetylcysteine in idiopathic pulmonary fibrosis. N Engl J Med 353:2229–2242

    Article  PubMed  CAS  Google Scholar 

Download references

Disclosures

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel Gerardo Fernandez-Avila.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Uribe, L., Ronderos, D.M., Díaz, M.C. et al. Antisynthetase antibody syndrome: case report and review of the literature. Clin Rheumatol 32, 715–719 (2013). https://doi.org/10.1007/s10067-013-2207-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-013-2207-5

Keywords

Navigation