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Rituximab in the treatment of antisynthetase syndrome
  1. L Brulhart,
  2. J-M Waldburger,
  3. C Gabay
  1. Division of Rheumatology, Department of Internal Medicine, University Hospital of Geneva, Geneva, Switzerland
  1. Correspondence to:
    Professor C Gabay
    Division of Rheumatology, Department of Internal Medicine, University Hospital of Geneva, 26 avenue Beau-Séjour, 1211 Geneva 14, Switzerland; cem.gabay{at}hcuge.ch

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The presence of autoantibodies directed against aminoacyl tRNA synthetases in the sera of patients with idiopathic inflammatory myopathy defines a specific clinical subset that has been called antisynthetase syndrome.1 The prognosis of these patients is conditioned by the increased incidence of interstitial lung disease compared with other types of myositis.2 We report a case of antisynthetase syndrome treated successfully with rituximab.

A 57 year old white woman had a 2 month history of painful synovitis of both hands, typical lesions of mechanic’s hands, and moderate proximal muscle weakness. Her laboratory evaluation showed a raised erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and muscle enzymes. Electromyography findings were consistent with the diagnosis of inflammatory myopathy. Prednisone 30 mg/day was immediately started with a good response and then progressively tapered to 10 mg/day.

After 3 months, she had a relapse with increased muscle enzyme levels and worsening of articular symptoms, …

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