A case of antisynthetase syndrome in a rheumatoid arthritis patient with anti-PL-12 antibody following treatment with etanercept

Clin Rheumatol. 2011 Mar;30(3):429-32. doi: 10.1007/s10067-010-1666-1. Epub 2011 Jan 11.

Abstract

In our earlier study, we had reported the case of a patient with rheumatoid arthritis (RA), who had anti-Jo-1 antibodies. This patient had received etanercept (ETN) therapy for RA, after which she had developed overt polymyositis (PM). Although various autoimmune phenomena, including lupus-like diseases, vasculitides, or psoriatic skin lesions, are associated with antitumor necrosis factor (TNF) therapy, the development of PM/dermatomyositis (DM) or antisynthetase syndrome following anti-TNF therapy is extremely rare. Here, we report a case of an RA patient with anti-PL-12 antibodies, who received ETN therapy and subsequently developed the antisynthetase syndrome. She recovered when ETN therapy was withdrawn and high-dose corticosteroid was administered. To date, there have been only five reported cases of RA patients with anti-Jo-1 antibodies who developed overt PM/DM following anti-TNF therapy and only one case of antisynthetase syndrome in an RA patient with anti-PL-7 antibodies. Our patients and the abovementioned reports strongly suggest that onset of overt PM/DM or antisynthetase syndrome in RA patients with anti-aminoacyl tRNA synthetase antibodies is associated with anti-TNF therapy.

MeSH terms

  • Amino Acyl-tRNA Synthetases / metabolism
  • Antibodies, Anti-Idiotypic / blood*
  • Antibodies, Anti-Idiotypic / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy
  • Etanercept
  • Female
  • Humans
  • Immunoglobulin G / therapeutic use*
  • Middle Aged
  • Myositis / complications
  • Receptors, Tumor Necrosis Factor / therapeutic use*

Substances

  • Antibodies, Anti-Idiotypic
  • Antirheumatic Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Amino Acyl-tRNA Synthetases
  • Etanercept

Supplementary concepts

  • Antisynthetase syndrome