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以肺部受累为主的抗合成酶综合征:一例报告

Antisynthetase Syndrome With Predominant Pulmonary Involvement: A Case Report.

作者信息

Lima Corrêa de Araújo Beatriz, Victor David R, Farias Fontes Heloísa Maria, Caminha Mendes Gomes Rayana Maria, Lima Corrêa de Araújo Leonardo

机构信息

Department of Internal Medicine, Hospital Barão de Lucena, Recife, BRA.

Medical School, Universidade de Pernambuco, Recife, BRA.

出版信息

Cureus. 2023 Aug 23;15(8):e43966. doi: 10.7759/cureus.43966. eCollection 2023 Aug.

Abstract

Antisynthetase syndrome (ASyS) is an autoimmune disease characterized by the presence of aminoacyl-transfer RNA synthetase antibodies. Its clinical presentation is variable and may include interstitial lung disease (ILD), myositis, arthritis, fever, Raynaud's phenomenon, and "mechanic's hands." ILD is more prevalent in this entity when compared to other idiopathic inflammatory myopathies and imparts greater severity to the condition. Here, we report the case of a 42-year-old female patient who sought care for severe ILD and persistent fever. Her diagnosis was made only after the detection of anti-Jo1 autoantibodies. Treatment was refractory to both prednisone monotherapy and cyclophosphamide pulse therapy, requiring the introduction of rituximab. A high degree of clinical suspicion is required to allow early diagnosis of ASyS in patients with pulmonary involvement in the absence of accompanying muscle weakness or other clinical symptoms.

摘要

抗合成酶综合征(ASyS)是一种自身免疫性疾病,其特征是存在氨酰 - 转运RNA合成酶抗体。其临床表现多样,可能包括间质性肺病(ILD)、肌炎、关节炎、发热、雷诺现象和“技工手”。与其他特发性炎性肌病相比,ILD在该疾病中更为普遍,且使病情更为严重。在此,我们报告一例42岁女性患者,她因严重ILD和持续发热前来就诊。仅在检测到抗Jo1自身抗体后才做出诊断。泼尼松单药治疗和环磷酰胺脉冲治疗均无效,需要使用利妥昔单抗。对于肺部受累但无伴随肌肉无力或其他临床症状的患者,需要高度的临床怀疑才能早期诊断ASyS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a83/10515292/1fe228506dbc/cureus-0015-00000043966-i01.jpg

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