Antisynthetase syndrome is a rare autoimmune, multisystem, inflammatory condition, characterised by autoantibodies against aminoacyl tRNA synthetases. The predominant features are myositis and interstitial lung disease but other symptoms such as Raynaud’s phenomenon may also be present. Described here is a 36-year-old woman with antisynthetase syndrome who planned and underwent a successful pregnancy, during which a multidisciplinary team approach secured a good outcome for both mother and baby.
BetteridgeZMcNughH.Myositis-specific autoantibodies: an important tool to support diagnosis of myositis (Review Symposium). J Intern Med2016;
280: 8–23.
2.
HamaguchiYFujimotoMMatusushitaT, et al.
Common and distinct clinical features in adult patients with anti-aminoacyl-tRNA synthetase antibodies: heterogeneity within the syndrome. PloS One2013;
8: e60442.
3.
Dalmau-CarolaJ.Letter to the editor: childbirth in a woman with antisynthetase syndrome and severe lung disease on long-term rituximab therapy. Indian J Rheum2016;
11: 116–118.
4.
SaikumarHMaselliDNambiarA. With child – a case of antisynthetase syndrome in pregnancy. B41 Antisynthetase syndrome and autoimmune myositis associated ILD: cases from the wards. Thematic Poster Session. In: AJRCCM conference 2017, Washington, DC, 19–24 May 2017.
5.
MarieIHatronP-YCherinP, et al.
Functional outcome and prognostic factors in anti-Jo1 patients with antisynthetase syndrome. Arthritis Res Ther2013;
15: R149.
6.
KempNNewnhamJChallisJ, et al.
The clinical use of corticosteroids in pregnancy. Hum Reprod Update2016;
22: 240–259.
7.
MottaMTincaniAMeroniP, et al.
Follow-up of children exposed antenatally to immunosuppressive drugs. Rheumatology (Oxford)2008;
47: iii32–iii34.
8.
FlintJPanchalSHurrellA, et al.
BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding – part 1: standard and biologic disease modifying anti-rheumatic drugs and corticosteroids. Rheumatology (Oxford)2016;
55: 1693–1697.
9.
AllenbachYGuiguetMRigoletA, et al.
Efficacy of rituximab in refractory inflammatory myopathies associated with anti-synthetase auto-antibodies: an open label, Phase II Trial. PLoS One2015;
10: e0133702.
10.
National Institute for Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management. [CG107]. NICE clinical guideline 107.
Manchester:
National Institute for Health and Care Excellence, 2011.
11.
MackillopL.Pre-eclampsia: reducing the risk with calcium supplements. BMJ Clin Evid2015;
12: 1402.
12.
JosephRHunterARayD, et al.
Systemic glucocorticoid therapy and adrenal insufficiency in adults: a systematic review. Semin Arthritis Rheum2016;
46: 133–141.
13.
MurthyRTheriaultRBarnettC, et al.
Outcomes of children exposed in utero to chemotherapy for breast cancer. Breast Cancer Res2014;
16: 500.
14.
La CorteRLo Mo NacoALocaputoA, et al.
In patients with antisynthetase syndrome the occurrence of anti-Ro/SSA antibodies causes a more severe interstitial lung disease. Autoimmunity2006;
39: 249–253.
15.
BaruteauA-EPassRThamboJ-B, et al.
Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management. Eur J Pediatr2016;
175: 1235–1248.
16.
KnightCNelson-PiercyC.Management of systemic lupus erythematosus during pregnancy: challenges and solutions. Open Access Rheumatol2017;
9: 37–53.
17.
BrucatoATincaniAFrediM, et al.
Should we treat congenital heart block with fluorinated corticosteroids?Autoimmun Rev2017;
16: 1115–1118.
PatelASowdenJ. Genes and pathways in optic fissure closure. Semin Cell Dev Biol. Epub ahead of print 29 November 2017. DOI: 10.1016/j.semcdb.2017.10.010.
21.
HornbySWardSGilbertC, et al.
Environmental risk factors in congenital malformations of the eye. Ann Trop Paediatr2002;
22: 67–77.