Antisynthetase syndrome (AS) is a rare systemic autoimmune disease characterized by the presence of anti-tRNA synthetase antibodies. Cardiac involvement (pericarditis) in AS is uncommon. Here, we present the case of a young African female who presented with acute pericarditis as an initial manifestation of AS. She was diagnosed with anti-Jo1 antisynthetase syndrome based on Connors criteria. Treatment with corticosteroids and azathioprine improved symptoms. This case underlines the importance for clinicians to evoke the possibility of an antisynthetase syndrome in the case of acute pericarditis.
References
[1]
Zanframundo, G., Faghihi-Kashani, S., Scirè, C.A., Bonella, F., et al. (2022) Defining Anti-Synthetase Syndrome: A Systematic Literature Review. Clinical and Experimental Rheumatology, 40, 309-319.
https://doi.org/10.55563/clinexprheumatol/8xj0b9
[2]
Adler, Y., Charron, P., Imazio, M., et al. (2015) ESC Guidelines for the Diagnosis and Management of Pericardial Diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal, 36, 2921-2964.
[3]
Chiabrando, J.G., Bonaventura, A., Vecchié, A., et al. (2020) Management of Acute and Recurrent Pericarditis: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 75, 76-92. https://doi.org/10.1016/j.jacc.2019.11.021
[4]
Hervier, B. and Benveniste, O. (2013) Clinical Heterogeneity and Outcomes of Antisynthetase Syndrome. Current Rheumatology Reports, 15, Article No. 349.
https://doi.org/10.1007/s11926-013-0349-8
[5]
Meudec, L., Jelin, G., Forien, M., Palazzo, E., Dieudé, P. and Ottaviani, S. (2019) Antisynthetase Syndrome and Cardiac Involvement: A Rare Association. Joint Bone Spine, 86, 517-518. https://doi.org/10.1016/j.jbspin.2018.09.019
[6]
Opinc, A.H. and Makowska, J.S. (2021) Antisynthetase Syndrome—Much More than Just a Myopathy. Seminars in Arthritis and Rheumatism, 51, 72-83.
https://doi.org/10.1016/j.semarthrit.2020.09.020
[7]
Galindo-Feria, A.S., Notarnicola, A., Lundberg, I.E. and Horuluoglu, B. (2022) Aminoacyl-tRNA Synthetases: On Anti-Synthetase Syndrome and Beyond. Frontiers in Immunology, 13, Article ID: 866087.
https://doi.org/10.3389/fimmu.2022.866087
[8]
Marco, J.L. and Collins, B.F. (2020) Clinical Manifestations and Treatment of Antisynthetase Syndrome. Best Practice & Research Clinical Rheumatology, 34, Article ID: 101503. https://doi.org/10.1016/j.berh.2020.101503
[9]
Aggarwal, R., Cassidy, E., Fertig, N., Koontz, D.C., Lucas, M., Ascherman, D.P. and Oddis, C.V. (2014) Patients with Non-Jo-1 Anti-tRNA-Synthetase Autoantibodies Have Worse Survival than Jo-1 Positive Patients. Annals of the Rheumatic Diseases, 73, 227-232. https://doi.org/10.1136/annrheumdis-2012-201800
[10]
Cavagna, L., Trallero-Araguás, E., Meloni, F., et al. (2019) Influence of Antisynthetase Antibodies Specificities on Antisynthetase Syndrome Clinical Spectrum Time Course. Journal of Clinical Medicine, 8, Article No. 2013.
[11]
Dieval, C., Deligny, C., Meyer, A., et al. (2015) Myocarditis in Patients with Antisynthetase Syndrome: Prevalence, Presentation, and Outcomes. Medicine, 94, e798.
https://doi.org/10.1097/MD.0000000000000798
[12]
Malaise, O., Gester, F., Anne-Sophie, T., Stella, M., Von Frenckell, C. and Malaise, M. (2015) Pericarditis Revealing an Anti-Jo-1 Anti-Synthetase Syndrome in an Elderly Patient. Belgian Congress of Rheumatology 2015, Genk, 23-25 September 2015.
[13]
Casal-Dominguez, M., Pinal-Fernandez, I., Huapaya, J., Albayda, J., Paik, J.J., Johnson, C., Silhan, L., Mammen, A.L., Danoff, S.K. and Christopher-Stine, L. (2019) Efficacy and Adverse Effects of Methotrexate Compared with Azathioprine in the Antisynthetase Syndrome. Clinical and Experimental Rheumatology, 37, 858-861.
[14]
Oddis, C.V. (2016) Update on the Pharmacological Treatment of Adult Myositis. Journal of Internal Medicine, 280, 63-74. https://doi.org/10.1111/joim.12511
[15]
Langlois, V., Gillibert, A., Uzunhan, Y., et al. (2020) Rituximab and Cyclophosphamide in Antisynthetase Syndrome-Related Interstitial Lung Disease: An Observational Retrospective Study. The Journal of Rheumatology, 47, 1678-1686.
https://doi.org/10.3899/jrheum.190505
[16]
Campochiaro, C., Farina, N., De Luca, G., Trignani, G., Tomelleri, A., Matucci-Cerinic, M. and Dagna, L. (2022) Anakinra for the Treatment of Antisynthetase Syndrome: A Monocentric Case Series and a Systematic Literature Review. The Journal of Rheumatology, Article ID: jrheum.220213.
https://doi.org/10.3899/jrheum.220213
