title: A Curious Case of Acute Respiratory Failure: Is It Antisynthetase Syndrome?
abstract: Antisynthetase (AS) syndrome is a major subgroup of inflammatory myopathies seen in a minority of patients with dermatomyositis and polymyositis. Although it is usually associated with elevated creatine phosphokinase level, some patients may have amyopathic dermatomyositis (ADM) like presentation with predominant skin involvement. Interstitial lung disease (ILD) is the main pulmonary manifestation and may be severe thereby determining the prognosis. It may rarely present with a very aggressive course resulting in acute respiratory distress syndrome (ARDS). We report a case of a 43-year-old male who presented with nonresolving pneumonia who was eventually diagnosed to have ADM through a skin biopsy without any muscle weakness. ADM may be associated with rapidly progressive course of interstitial lung disease (ADM-ILD) which is associated with high mortality. Differentiation between ADM-ILD and AS syndrome may be difficult in the absence of positive serology and clinical presentation may help in clinching the diagnosis.
authors.affiliation: University of Illinois at Chicago, Chicago, IL 60612, USA.
authors.forename: Gurveen
authors.identifier: 0000-0001-7661-9967
authors.initials: G
authors.lastname: Malhotra
authors.affiliation: Internal Medicine, Mount Sinai Hospital, Chicago, IL 60608, USA.
authors.forename: Nitya
authors.identifier: 0000-0001-5583-4596
authors.initials: N
authors.lastname: Ramreddy
authors.affiliation: Rheumatology, Mount Sinai Hospital, Chicago, IL 60608, USA.
authors.forename: Serafin
authors.initials: S
authors.lastname: Chua
authors.affiliation: Pulmonary & Critical Care Medicine, Mount Sinai Hospital, Chicago, IL 60608, USA.
authors.forename: Mira
authors.initials: M
authors.lastname: Iliescu
authors.affiliation: University of Illinois at Chicago, Chicago, IL 60612, USA.
authors.forename: Tanjeev
authors.identifier: 0000-0003-1455-5886
authors.initials: T
authors.lastname: Kaur