Antisynthetase syndrome with stroke

摘要

Sir,Antisynthetase syndrome (ASS) is a rare autoimmune disease of unknown etiology. The hallmark of the disorder is the presence of serum autoantibodies, which recognize the aminoacyl-tRNA synthetases, a family of intracytoplasmic enzymes that play a role in protein synthesis.[1] The clinical characteristics of ASS include myositis; interstitial lung disease, and chronic articular involvement either alone or in combination. Involvement of various systems has been reported in ASS, neurological manifestations have not been reported previously.A 52-year-old female presented with acute onset right upper and lower limb weakness 8 hours after onset. She had history of polyarthritis and exertional dyspnea for which she was evaluated and diagnosed as interstitial lung disease and was on irregular treatment with steroids and immunosuppressants. She did not have history suggestive of photosensitivity, Raynaud's phenomenon or myalgia. General examination revealed "mechanic's hands" and respiratory system examination showed fine inspiratory crepitations. Neurological examination revealed conscious and mute patient with grade 3/5 power in right upper limb and grade 0/5 power in right lower limb with National Institute of Health Stroke Scale score of 17.