Anti-synthetase syndrome occurring after SARS-CoV-2 infection

Marmen, Mariève Bouchard; Ellezam, Benjamin; Fritzler, Marvin J.; Troyanov, Yves; Gould, P. W.; Satoh, Minoru; Meyer, A; Mahjoub, Zeineb

doi:10.1080/03009742.2021.2024019

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…Mild thoracic, abdominal, and pelvic lymphadenopathy, non-specific. Mild mesenteric stranding may be secondary to mesenteric panniculitis, with possible pancreatitis Proteinuria Holzer et al 2022 [ 19 ] 14 – < 5 – – CK 19,647 Positive ANA: 1:640 Positive anti-NXP2 MRI muscle: Bilateral myositis of muscles of the pelvic hip girdle and thighs Giuggioli et al 2022 [ 41 ] 28 – 65 – – Positive ANA, anticentromere pattern Nailfold capillaroscopy: “early scleroderma pattern” Chandra and Kahaleh 2022 [ 42 ] – – – – Positive ANA > 1:1280 HRCT chest: interstitial lung disease, findings suggestive of non-specific interstitial pneumonia Bouchard Marmen et al 2022 [ 43 ] 28 – 61 – – CK 7696, Positive ANA and anti-Jo-1 CT thorax: missed opacities with sub segmental consolidation MRI: oedema of the gluteal and thigh muscles consistent with myositis Blum et al 2022 [ 44 ] 91 – – – – Positive ANA Positive anti-RNP and ani-SSA antibodies CT chest: ground-glass opacities possibility indicating interstitial lung disease Assar et al 2022 [ 32 ] 18 53 …”

Section: Resultsmentioning

confidence: 99%

“…Subsequent hydroxychloroquine 400 mg/day and prednisolone 1 mg/kg/day (dose not specified) Yes Yes Survived Kazzi et al 2022 [ 31 ] Low None SLE No Antibiotics, corticosteroids and MMF 1500 mg twice daily with resolution. Subsequent hydroxychloroquine (dose unspecified) No Yes Survived Holzer et al 2022 [ 19 ] Unknown Unknown Dermatomyositis Unknown Corticosteroids, IVIG, MMF, ciclosporin A, tofacitinib, rituximab No Yes Survived Giuggioli et al 2022 [ 41 ] Unknown Azithromycin for 5 days; hydroxychloroquine 400 mg twice a day for 1 day and then 200 mg every 12 h for 5 days Raynaud's and systemic sclerosis No Nifedipine for Raynaud’s No Yes Survived Chandra & Kahaleh 2022 [ 42 ] Unknown Unknown Systemic Sclerosis No MMF 1500 mg twice daily, amlodipine 5 mg daily, methotrexate 12.5 mg once weekly, prednisone 5 mg twice daily No No Survived Bouchard Marmen et al 2022 [ 43 ] Unknown Unknown Anti-synthetase syndrome Unknown Pulsed IV methylprednisolone, then oral prednisolone, cyclophosphamide, rituximab, IVIG Yes Yes Survived Blum et al 2022 [ 44 …”

Section: Resultsmentioning

confidence: 99%

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A systematic review of the incidence, management and prognosis of new-onset autoimmune connective tissue diseases after COVID-19

et al. 2023

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A literature review on new-onset autoimmune connective tissue diseases (ACTDs) following COVID-19 is lacking. We evaluated potential associations between COVID-19 and the development of new-onset ACTDs. The “population” was adults with disease terms for ACTDs, including systemic lupus erythematosus (SLE), Sjogren’s syndrome, systemic sclerosis (SSc), idiopathic inflammatory myositis (IIM), anti-synthetase syndrome, mixed CTD and undifferentiated CTD, and “intervention” as COVID-19 and related terms. Databases were searched for English-language articles published until September 2022. We identified 2236 articles with 28 ultimately included. Of the 28 included patients, 64.3% were female, with a mean age was 51.1 years. The USA reported the most cases (9/28). ACTD diagnoses comprised: 11 (39.3%) IIM (including four dermatomyositis); 7 (25%) SLE; four (14.3%) anti-synthetase syndrome; four (14.3%) SSc; two (7.1%) other ACTD (one lupus/MCTD overlap). Of eight, four (14.3%) patients (including that with lupus/MCTD) had lupus nephritis. The average time from COVID-19 to ACTD diagnosis was 23.7 days. A third of patients were admitted to critical care, one for treatment of haemophagocytic lymphohistiocytosis in SLE (14 sessions of plasmapheresis, rituximab and intravenous corticosteroids) and nine due to COVID-19. 80% of patients went into remission of ACTD following treatment, while three (10%) patients died—one due to macrophage activation syndrome with anti-synthetase syndrome and two from unreported causes. Our results suggest a potential association between COVID-19 and new-onset ACTDs, notably in young females, reflecting more comprehensive CTD epidemiology. The most common diagnosis in our cohort was IIM. The aetiology and mechanisms by which ACTDs emerge following COVID-19 remain unknown and require further research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A systematic review of the incidence, management and prognosis of new-onset autoimmune connective tissue diseases after COVID-19

et al. 2023

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“…Further tests including positive anti-Jo1 and muscle biopsy con rmed ASSD [4]. This case report found that the patient had features of myalgia, fatigue and muscle weakness which were initially presumed to be due to a viral illness.…”

Section: Discussionmentioning

confidence: 69%

“…The proposed diagnostic criteria for ASSD includes presence of a serum anti-synthetase antibody and at least one of the following clinical manifestations: arthritis, ILD, Raynaud's phenomenon, Mechanic's hands or fever [3]. There have been reported cases of antisynthetase syndrome following Sars-CoV-2 infection [4]. We here report the rst anti-OJ antibody-positive ASSD following SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 85%

Anti-OJ antibody-positive anti-synthetase syndrome following SARS-CoV-2 infection: a case report and literature review

Sia,

Massouridis,

Kee

et al. 2024

Preprint

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Background: COVID-19 can induce a systemic inflammatory response with variable clinical manifestations. Similar to various viruses, COVID-19 has been implicated in the pathogenesis of autoimmune diseases. This article highlights the potential for infections including the SARS-CoV-2 virus to induce exacerbations of pre-existing autoimmune diseases or even potentially unmask de novo autoimmune diseases in particular anti-synthetase syndrome (ASSD) in predisposed individuals. Although there are other case reports of ASSD following SARS-CoV-2 infection, here we present the first reported case of a gentleman with a newly diagnosed anti-OJ positive anti-synthetase syndrome following SARS-CoV-2 infection. Case presentation: Described is a case of a 70-year-old man presenting to the emergency department with worsening dyspnea in the context of a recent COVID-19 infection. CT-chest revealed changes suggestive of fibrotic lung disease, consistent with usual interstitial pneumonitis (UIP) pattern. Despite recovery from his COVID-19 illness, the patient subsequently developed proximal myopathy with cervical flexion weakness on further assessment with persistently elevated creatinine kinase (CK). Myositis autoantibodies found a strongly positive anti-OJ autoantibody with MRI-STIR and muscle biopsy performed to further confirm the diagnosis. The patient received pulse methylprednisolone 1g for 3 days with a long oral prednisolone wean and in view of multiple end-organ manifestations, loading immunoglobulin at 2g/kg administered over two days was given. In addition, he was then commenced and escalated to a full dose of azathioprine given a normal purine metabolism where he remains in clinical remission to this date. At least 267 cases of rheumatic diseases has been associated with SARS-CoV-2 infection as well as COVID-19 vaccination. A literature search on PubMed was made to determine the amount of case reports describing myositis associated with SARS-CoV-2 infection. We found 3 case reports that fit into our inclusion criteria. Further literature searches on diagnostic approach and treatment of ASSD were done. Conclusion: Although SARS-CoV-2 infection itself can cause a directly mediated viral myositis, this case report highlights the possibility of developing virus-triggered inflammatory myositis through multiple aforementioned proposed mechanisms. Therefore, further studies are required to explore the relationship and pathophysiology of SARS-CoV-2 infection and the incidence of inflammatory myopathies.

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“…Currently, only a few cases of ASS following COVID-19 have been reported [4][5][6][7]. Here, we present a case of ASS with confirmed positive anti-EJ autoantibodies that developed after COVID-19.…”

Section: Introductionmentioning

confidence: 88%

A Case of Anti-Synthetase Syndrome With Anti-Glycyl tRNA Synthetases Antibody Developed After COVID-19

Irie,

Wakabayashi,

Matuzawa

et al. 2024

Cureus

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Coronavirus disease 2019 (COVID-19) is a life-threatening respiratory disease characterized by severe acute infection. In some cases, COVID-19 symptoms may persist for a long term, posing a significant social problem. Long-term COVID-19 symptoms resemble those observed in various autoimmune diseases, such as dermatomyositis and polymyositis. In this report, we present the case of a 55-year-old woman who had been experiencing persistent dyspnea on exertion since contracting COVID-19 a month ago and was subsequently diagnosed with anti-synthetase syndrome (ASS). The patient presented with fever, dyspnea, rash, mechanic's hands, and arthritis. Computed tomography imaging revealed findings indicative of interstitial pneumonia. Immunological test results were positive for anti-EJ antibody, leading to a diagnosis of ASS based on Solomon's established criteria. The patient's condition improved following treatment with prednisolone, tacrolimus, and intravenous cyclophosphamide. Pathological findings of transbronchial biopsy revealed nonspecific interstitial pneumonia with organizing pneumonia, leading to speculation that ASS had developed after COVID-19. Given the scarcity of reports on ASS development post COVID-19, we conducted a literature review and compared our present case to previous ones. This report highlights the importance of considering ASS in the differential diagnosis of patients with long-term COVID-19 symptoms.

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Anti-synthetase syndrome occurring after SARS-CoV-2 infection

Cited by 5 publications

References 9 publications

A systematic review of the incidence, management and prognosis of new-onset autoimmune connective tissue diseases after COVID-19

A systematic review of the incidence, management and prognosis of new-onset autoimmune connective tissue diseases after COVID-19

Anti-OJ antibody-positive anti-synthetase syndrome following SARS-CoV-2 infection: a case report and literature review

A Case of Anti-Synthetase Syndrome With Anti-Glycyl tRNA Synthetases Antibody Developed After COVID-19

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