A rare case of anti-jo1 syndrome presenting as a interstitial lung disease

Antisynthetase syndrome is a rare entity and can be missed if not specifically looked in patients whose initial presentation is with Interstitial Lung Disease. Prognosis is altered when patients presenting with Interstitial Lung Disease. A 45 years old lady with no known comorbidities came with complaints of fever, breathlessness and cough for 4 months. She also had history of muscle weakness. She was treated as COVID pneumonia with oral steroids as her CT chest showed bilateral GGO's. When she came to our hospital she was afebrile, hemodynamically stable, SPo2-88% on room air. She was negative for COVID and COVID antibodies were also negative. On Investigations her CPK, Aldolase, CKMB were elevated. Her ENA profile showed positive anti-Jo1 and anti Ro 52 antibodies. Electromyography and Muscle biopsy suggestive of Inflammatory Myopathy. PFT showed restrictive pattern with reduced Diffusing Capacity of Lung for Carbon Monoxide(DLCO). She was treated with high dose oral steroids and cyclophosphamide. She responded well to the treatment and discharged. Though antisynthetase syndrome is a rare disease, we should keep in mind when patients presenting with interstitial Lung disease. Patients presenting with ILD have guarded prognosis.