Quick response to rituximab in a patient with Ro52-Jo1 complex-associated antisynthetase syndrome debuting with rapidly progressive interstitial lung disease and diffuse alveolar haemorrhage

Ana Esteban-Molina, Rheumatology Unit, Hospital Universitario Infanta Sofía, Madrid, Spain
Tatiana Cobo-Ibanez, Rheumatology Unit; Universidad Europea de Madrid; Hospital Universitario Infanta Sofía, Madrid, Spain
Gema Mora, Universidad Europea de Madrid; Pneumology Unit; Hospital Universitario Infanta Sofía, Madrid, Spain
Martha Vidal, Pneumology Unit, Hospital Universitario Infanta Sofía, Madrid, Spain
Cristina Bayon-Garcia, Intensive Care Unit. Hospital Universitario Infanta Sofía, Madrid, Spain
Santiago Munoz-Fernandez, Rheumatology Unit; Universidad Europea de Madrid; Hospital Universitario Infanta Sofía, Madrid, Spain

Antisynthetase syndrome (AAS) is an inflammatory myopathy that may debut with interstitial lung disease (ILD). A few studies show cases in which patients with high concentrations of anti-Ro52 in patients with ILD might achieve a better response if treated with rituximab than other patients with ILD and Ro-52 whose levels are lower. We present a patient with lung involvement as the first and unique manifestation of AAS with anti-Jo and anti-Ro52-positive antibodies. The ILD was rapid and progressive and led him into the intensive care unit in a matter of days, despite several immunosuppressive treatments. As soon as the patient received this treatment, he experienced an improvement. We therefore suggest the prompt determination of anti-Ro52 antibody concentrations in this subgroup of patients, which would offer a therapeutic approach based first on rituximab over other immunosuppressive treatments.

Palabras clave: Antisynthetase syndrome. anti Ro-52. anti Jo1. alveolar haemorrhage. Rituximab.