Interstitial Lung Disease and Myositis in a Patient With Antisynthetase Syndrome and PL12 and Ro52 Co-positivity in a Retired Medical Officer.

Military Medicine
Michael F LoncharichJess Edison

Abstract

Antisynthetase syndrome (ASS) is an idiopathic inflammatory myopathy characterized by myositis, arthritis, interstitial lung disease (ILD), Raynaud's phenomenon, and distinctive cutaneous manifestations. Anti-PL12 is a rare myositis-specific autoantibody classically associated with an amyopathic presentation and rapidly progressive ILD. Anti-Ro52 is a myositis-associated antibody that has been postulated to be directly pathogenic in inflammatory myopathy patients. The disease phenotype, course, and response to treatment associated with anti-PL12 and anti-Ro52 co-positivity is not well described. A 58-year-old man with anti-PL12 and anti-Ro52 ASS presented with rapidly progressive ILD and myositis refractory to high-dose prednisone. He ultimately required a dexamethasone burst with intravenous immunoglobulin and mycophenolate mofetil for disease control. Severe and rapidly progressive myositis is infrequently reported in anti-PL12 ASS. This case suggests that concurrent anti-Ro52 positivity predicts a more aggressive disease phenotype and may require more initial immunosuppression. If rapid progression of this disease were to occur in an active duty service member, it would have significant implications for readiness and potenti...Continue Reading

References

Oct 12, 2007·Clinical Rheumatology·Vidya S LimayeDavid Gillis
Mar 10, 2012·Journal of Autoimmunity·Vilija Oke, Marie Wahren-Herlenius
Feb 23, 2013·La Presse médicale·Isabelle MarieFabienne Jouen
Aug 13, 2015·Medicine·Lorenzo CavagnaUNKNOWN AENEAS (American, European NEtwork of Antisynthetase Syndrome) collaborative group
Oct 17, 2015·Joint, Bone, Spine : Revue Du Rhumatisme·Amandine BeaumelFabienne Coury

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