Antisynthetase syndrome: Pulmonary computed tomography findings of adult patients with antibodies to aminoacyl-tRNA synthetases

AbstractObjectivesTo describe the pulmonary CT findings in patients with anti-ARS-antibody-positive interstitial lung disease (anti-ARS-ILD)MethodsThe CT findings of 64 patients with anti-ARS-ILD were retrospectively reviewed. The images were retrospectively reviewed independently by 2 chest radiologists, and the final decision on the CT findings was made by a third chest radiologist.ResultsThere were 16 male and 48 female patients, aged 54.2±13.4 years. Sixteen patients had anti Jo-1, 24 had anti-EJ, 9 had anti-PL-7, 7 had anti-PL-12, 5 had anti-KS, and 3 had anti-OJ antibodies. Overall, 63 patients (98.4%) had CT findings predominantly in the lower lobe; 61 patients (95.3%) showed peripheral opacities, and 47 patients (73.4%) showed peribronchovascular opacities. Ground-glass attenuation, consolidation, and reticulation showed similar distribution patterns. Regarding detailed CT findings, 89.1% of patients had lower volume loss, 76.6% had interlobular septal thickening, and 67.2% had thickening of bronchovascular bundles. The final radiologic diagnoses were as follows: inconsistent with usual interstitial pneumonia (UIP) in 63 patients (98.4%), which included nonspecific interstitial pneumonia (NSIP) in 35 patients (55.6%), organizing pneumonia (OP) in 4 patients (6.3%), and OP with fibrosis in 22 patients (34.9%).ConclusionsThe characteristic CT findings of patients with anti-ARS-ILD were areas of ground-glass attenuation and reticulation, predominantly distributed as lower and peribronchovascular lesions, which is compatible with NSIP. One-third of patients showed OP with fibrosis

A New ELISA for Dermatomyositis Autoantibodies: Rapid Introduction of Autoantigen cDNA to Recombinant Assays for Autoantibody Measurement

Advances in immunology, biochemistry, and molecular biology have enabled the development of a number of assays for measuring autoantibodies. ELISA has been widely used, because it can deal with relatively large numbers of serum samples more quickly than other immunologic methods, such as immunoblotting and immunoprecipitation. Recombinant autoantigens, which are generally produced in E. coli using the relevant cloned cDNA, are necessary for ELISA. Conventional clinical ELISA tests are limited in their ability to purify proteins free of bacterial contaminants, and the process is labor intensive. We recently developed new ELISA tests that utilize simple in vitro transcription and translation labeling of autoantigens in order to measure dermatomyositis- (DM-) specific autoantibodies, including autoantibodies to Mi-2, MDA5, NXP-2, TIF1-α, and TIF1-γ. This method may allow for the rapid conversion of cDNAs to a chemiluminescent ELISA to detect autoantibodies that are found not only in DM but also in other autoimmune diseases

Hydroxyurea-induced amyopathic dermatomyositis presenting with heliotrope erythema

Hydroxyurea (HU) is a chemotherapeutic agent used for the treatment of myeloproliferative disorders such as chronic myeloid leukemia, polycythemia vera, and essential thrombocytosis. We describe a 69-year-old man who had essential thrombocytosis and developed amyopathic dermatomyositis after long-term HU therapy. He presented with Gottron papules and heliotrope erythema. The former has been described in all cases of HU-induced dermatomyositis; the latter has been seen in a few cases of that disorder