CO23 | Anti-Ro52 associated with Anti-EJ antibodies may predict more severe lung damage in patients with anti-synthetase syndrome

Premises: Anti-synthetase syndrome (ASSD) is a rare autoimmune disease characterized by serologic positivity for anti-synthetase antibodies. The lungs emerge as the predominantly impacted organ, typically presenting with manifestations of interstitial lung disease (ILD). The clinical presentation and progression of the disease may vary depending on the specific anti-synthetase antibody present.Description of the Case report: A 45 yrs old patient was admitted with a 2-month history of progressive dyspnea with no other symptoms; ANA test (IFI on Hep2) was positive at a titer of 1:160, and his anti-synthetase antibodies were positive for EJ and Ro52. Other tests (including ENA, anti-DNA, C3, C4 and Echocardiogram) were normal. CT scan showed diffuse interstitial infiltrates in both lungs while the spirometry showed only a slight reduction in the DLCO. The physical examination was unremarkable. Based on clinical presentation and laboratory findings, a diagnosis of ASSD was made and the patient started oral cyclosporine and prednisone with gradual improvement of symptoms. We have scheduled appropriate tight control and follow-up with our multidisciplinary team including a respiratory physicians and an expert ILD radiologist.Conclusions: Different ASSD phenotypes could be related to incidence and severity of ILD and the presence of anti-Ro52 antibodies, in conjunction with Anti-EJ antibodies, could prove valuable not only for their potential to raise diagnostic suspicions but also in their observed association with a higher incidence of ILD and progression of the disease.