Why the study?
Most patients with anti-KS antibody-related interstitial lung disease present with chronic disease, making severe acute presentations poorly documented.
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KS-ILD can present acutely with fulminant respiratory failure, and ECMO can be a useful bridge to diagnosis and recovery.
Anti-asparaginyl transfer RNA (tRNA) synthetase (KS) antibodies, detected in <5% patients with anti-aminoacyl-tRNA synthetase antibody syndrome, are strongly associated with interstitial pneumonia but not myositis and skin symptoms. A recent report suggested that most patients with interstitial pneumonia and anti-KS antibody (KS-ILD) may present with chronic disease. We herein report a rare case of severe acute respiratory failure in a KS-ILD patient requiring extracorporeal membrane oxygenation (ECMO). ECMO is useful for facilitating not only lung rest until recovery but also the definitive diagnosis and treatment of ILD. KS-ILD can develop acutely with fulminant respiratory failure, as observed in this case.
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Oda et al. (2022) studied this question.
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