Remitting seronegative symmetrical synovitis with pitting edema is a rare but well-recognized clinical entity that is easily overlooked due to lack of clinical vigilance. It is classically described as an acute onset of symmetrical tenosynovitis of both upper and lower extremities with pitting edema, mostly noted in elderly population. Young patients with other rheumatological diseases and unilateral involvement had also been reported, but symmetrical remitting seronegative symmetrical synovitis with pitting edema in a young patient is a rare observation. We hereby report a case of a remitting seronegative symmetrical synovitis with pitting edema in a young male affected by no rheumatological diseases in the past, typically fulfilling the diagnostic criteria and well responded to low-dose steroid therapy. The salient features of the present case in terms of age, remitting seronegative symmetrical synovitis with pitting edema possibly related to undifferentiated arthropathy, reactive arthritis, or diabetes mellitus.

Anti-synthetase syndrome (ASS) is an autoimmune disease characterized by the presence of auto antibodies against one of many aminoacyl transfer RNA synthetases and spectrum of clinical manifestations. Here we report a case of a 52 year old lady who had been extensively evaluated for progressive muscle weakness in a tertiary care center, diagnosed as Antisynthetase syndrome which was evidenced by the presence of antisynthetase antibody, dermatomyositis, Raynaud's phenomenon, arthritis and mechanics hand. Despite aggressive management with intravenous immunoglobulins, steroids and immune suppressors she died because of underlying respiratory failure causing difficulty in weaning off ventilator.

Inflammatory myopathies represent largest group of acquired and potentially treatable cause of skeletal muscle weakness. The goal of therapy is to improve muscle strength and thereby improving function in activities of daily living and ameliorate extra muscular manifestations.