Pulmonary hypertension secondary to seronegative rheumatoid arthritis overlapping antisynthetase syndrome:A case report  

作　　者：Cheng-Yan Huang Ming-Jie Lu Jia-Hua Tian Dai-Shun Liu Chun-Yan Wu 

机构地区：[1]Department of Respiratory Medicine,The Third Affiliated Hospital of Zunyi Medical University(The First People’s Hospital of Zunyi),Zunyi 563000,Guizhou Province,China [2]Clinical School,Zunyi Medical University,Zunyi 563000,Guizhou Province,China

出　　处：《World Journal of Clinical Cases》2022年第27期9851-9858,共8页世界临床病例杂志

基　　金：Supported by the Natural Science Foundation of China,No.82060010。

摘　　要：BACKGROUND Polyarthritis is the most frequent clinical manifestation in antisynthetase syndrome(ASS)forms of idiopathic inflammatory myositis and may be misdiagnosed as rheumatoid arthritis(RA),particularly in patients with seronegative RA(SNRA).It is unclear whether there is an overlap between ASS and RA,or if ASS sometimes mimics RA.Pulmonary hypertension(PAH)is common in connective tissue diseases(CTDs).However,published reports on CTD-PAH do not include overlapping CTDs,and its incidence and impact on patient prognosis are unclear.CASE SUMMARY We report the case of a 63-year-old woman who presented with a 3-mo history of symptom aggravation of recurrent symmetrical joint swelling and pain that had persisted for over 10 years.The patient was diagnosed with RA and interstitial lung disease.The patient repeatedly presented to the hospital’s respiratory and rhe-umatology departments with arthralgia,plus shortness of breath after activity.Relevant tests indicated that anti-CCP and RF remained negative,while anti-J0-1 and anti-Ro-52 were strongly positive.It was not until recently that we recognized that this could be an unusual case of SNRA with concurrent ASS.Joint pain was relieved after regular anti-rheumatic treatment.Chest computed tomography scans showed that pulmonary interstitial changes did not progress significantly over several years;however,they showed gradual widening of the pulmonary artery,and cardiac ultrasound indicated elevated pulmonary artery systolic pressure.The prescribed treatment of PAH was not effective in improving shortness of breath.CONCLUSION Overlap of RA and ASS may be missed.Further research is necessary to facilitate early diagnosis,effective evaluation,and prognosis.

关 键 词：Rheumatoid arthritis ARTHRITIS Antisynthetase syndrome Pulmonary hypertension Pulmonary arterial hypertension Case report 

分 类 号：R593.22[医药卫生—内科学] R544.1[医药卫生—临床医学]