SINDROME ANTISINTETASA EN TIEMPO DE PANDEMIA

Abstract

Introduction Introduction: The Antisynthetase Syndrome is a rare entity that is included within the idiopathic inflammatory myopathies, characterized by the presence of antisynthetase antibodies, they can be found in 39.1% of the patients with these myopathies. The affectation is systemic being the main ones at the articular level in 40% -80%. Lung damage occurs in 60% -80%, the most frequent findings being ground glass, predominantly crosslinking in lower segments, probably with a pattern of non-specific interstitial pneumonia, organized pneumonia, or mixed patterns. Regarding muscle involvement, it occurs in 60% -80%. Treatment is based on the use of corticosteroids, immunosuppressants, and biological agents. Case description A 38-year-old female patient with no significant clinical or family history was approached, single (no children), who presented gradual and intermittent joint pain and muscle weakness associated with progressive dyspnea, in the context of The current pandemic was swabbed for SARS-COV-2 on two occasions as well as antibodies for the same virus being negative, with tomographic findings compatible with an alternative pattern, despite the aforementioned, it was treated in a particular way with a scheme directed towards COVID -19, with partial resolution of the symptoms and subsequent exacerbation of the same, for which he went to hospital care, where the swab was repeated obtaining negativity of the same, deciding on this occasion an evaluation by the Pneumology Service and hospitalization. During his stay, an immunological panel was performed where a weak elevation of rheumatoid factor is evidenced, due to logistical issues Myositis panel we are waiting, however, due to the lack of specific etiology, it was decided to perform a lung biopsy reporting a concordant pattern of organized pneumonia With the tomographic diagnosis, the evolution of the patient was favorable with supportive treatment until the results of the external immunological panel were received, evidencing a marked elevation of the anti-Jo antibody, added to the clinical and image manifestations, the picture is cataloged as an Antisynthetase Syndrome. Thus, with the support of rheumatology, treatment with corticosteroids (methylprednisolone), immunosuppressants (mycophenolate) and biological agent (rituximab) is started; with which there was significant clinical improvement, decrease in o2 support as well as lung lesions, with which we proceeded to discharge with the respective follow-up by the services involved. Conclusions: As we evidenced in the clinical case, in a retrospective way, we can assert that it complied with the clinical manifestations of the disease, although we are experiencing a pandemic where lung involvement is important, once it has been ruled out, other diagnostic possibilities must be addressed. As in the patient, it culminated in the presentation of a rheumatological picture with lung damage.