A CURIOUS CASE OF FEVER AND INTERSTITIAL LUNG DISEASE
Dr. Shahid Mahdi
Dr. Darpanarayan Hazra
Dr. Zainab Mahdi
Antisynthetase syndrome | anti Jo-1 antibodies | ILD with myositis | ILD with Raynaud's phenomenon
Antisynthetase syndrome is a rare chronic autoimmune inflammatory myopathy with fever, interstitial lung disease, Raynaud’s phenomenon and polyarthritis. The exact underlying cause of antisynthetase syndrome is not yet known. Diagnosis is made with presence of Jo-1 (Histydyl t RNA synthase) antigen in a patient with underlying interstitial lung disease, myositis, arthritis, Raynaud’s phenomenon and mechanic’s hand. Some of the other antisynthetase anti bodies are PL-7 (antigen – threonyl-tRNA synthase), PL-12 (antigen - Alanyl-tRNA synthetase), OJ (antigen – Isoleucyl-tRNA synthetase), EJ (antigen - Glycyl-tRNA synthetase), KS (Antigen – Asparaginyl-tRNA synthetase, WA (Antigen- Autoantibody to a 48 kDa transfer RNA related protein), YRS (antigen - Tyrosyl-tRNA synthetase) however the prevalence is found to be highest with anti Jo-1 antibody (25-30%). In a patient with nonspecific interstitial pneumonitis, Raynaud’s phenomenon and arthralgia antisynthetase syndrome can be best diagnosed with anti ZO ab, though prevalence of the disease is not yet known and in a patient with usual interstitial pneumonitis and fever diagnosis of anti synthetase syndrome can be made with anti KS antibodies. Symptomatic treatment is preferred, which may include immunosuppressive therapy and corticosteroids especially in a patient with muscle and lung involvement.