Combined lung fibrosis and 'mechanic's hand': a clinical diagnostic clue to amyopathic antisynthetase syndrome.
Combined interstitial lung disease and the presence of 'mechanic's hands' could be a clinical clue in the early diagnosis of the rare disease, amyopathic antisynthetase syndrome for which anti-Jo-1 antibody is a useful diagnostic tool. The case is reported of a patient who suffered from shortness of breath and dry cough, with pulmonary fibrosis on CXR and CT scan, and interstitial pneumonitis on trans-bronchial biopsy. She was also positive for anti-Jo-1 and anti-Ro antibodies. 'Mechanic's hands' were noted bilaterally but with no evidence of myopathy in either the electromyogram or on muscle biopsy. The patient was treated with prednisolone and her clinical picture, including the 'mechanic's hands' and lung fibrosis, subsided gradually, suggesting that the sign may be a useful follow up tool in this disease. Early diagnosis and corticosteroid therapy could be beneficial for these patients.
Yang
Chih-Jen
CJ
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Sheu
Chau-Chyun
CC
Ou
Tsan-Teng
TT
Hwang
Jhi-Jhu
JJ
Huang
Ming-Shyan
MS
D000974:Antibodies, Antinuclear / Q000276:immunology; D015352:Dry Eye Syndromes / Q000276:immunology; D005260:Female; D006229:Hand Dermatoses / Q000276:immunology*; D006801:Humans; D007642:Keratosis / Q000276:immunology*; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000276:immunology*; D013577:Syndrome; D014057:Tomography, X-Ray Computed
D000974:Antibodies, Antinuclear; C046750:Jo-1 antibody; C035356:SS-A antibodies