ABSTRACT
Antisynthetase syndrome is an autoimmune disease affecting multiple organ systems that was first described as a triad of polymyositis, interstitial lung disease, and the presence of autoantibodies to aminoacyl-transfer ribonucleic acid synthetases. We describe a patient who developed respiratory symptoms following fume exposures. Following a prednisone taper for presumed hypersensitivity pneumonitis, he developed extrapulmonary symptoms suspicious for an autoimmune process discovered to be antisynthetase-associated interstitial lung disease and myositis. This case demonstrates the importance of avoiding anchoring to minimize morbidity and potentially mortality.
ABSTRACT
Chronic eosinophilic pneumonia (CEP) is an eosinophilic lung disease that is typically diagnosed by a triad of clinical symptoms including pulmonary symptoms, eosinophilia and characteristic radiographic abnormalities. It requires a high index of suspicion given its overlap with other eosinophilic conditions and lack of a specific diagnostic test. The diagnosis is made after careful consideration of other secondary causes of eosinophilia, such as infectious, drugs, or toxic etiologies. CEP generally responds rapidly to treatment, which primarily consists of corticosteroid therapy, but relapses are common. Novel therapies are being explored as more information is being discovered about the pathophysiology of eosinophilic disease processes. Close follow-up is important given the difficulty in weaning patients from glucocorticoids with many patients developing sequelae of chronic glucocorticoid therapy. Therefore, exploring alternative treatments is of upmost importance.
