The Disappearance of a Hepatic Mass in Anti-Synthetase Syndrome

Christopher J Mesa, MD*; Mona Arasoghli, MD; Pawan Suri, MD; Swati Pathak, MD; Shante Hinson, MD

 Lincoln Medical and Mental Health Center; Bronx, NY, USA

*Corresponding author: Christopher J Mesa, MD. Division of Rheumatology, Department of Internal Medicine, Lincoln Medical and Mental Health Center; Bronx, NY, USA.

Published: June 16, 2017.  doi: 10.21103/Article7(2)_CR2


Anti-Synthetase Syndrome (ASyS) is a rare chronic autoimmune disorder characterized by myositis, interstitial lung disease (ILD), polyarthralgia,  “mechanic’s hands” and Raynaud’s phenomenon. Liver lesions are quite rare in ASyS.  In our ASyS case, we will discuss a 58-year-old man presenting with muscle weakness, arthralgia, and interstitial lung disease (ILD). He was positive for anti-Jo-1 antibodies, substantiating the diagnosis, and was started on treatment. This was followed by the appearance of a liver mass that disappeared when the patient achieved remission.

Anti-Synthetase Syndrome ● anti-Jo-1 antibody ● nodular regenerative hyperplasia ● treatment
  1. Mahler M1, Miller FW2, Fritzler MJ3. Idiopathic inflammatory myopathies and the anti-synthetase syndrome: a comprehensive review. Autoimmun Rev. 2014 Apr-May;13(4-5):367-71. doi: 10.1016/j.autrev.2014.01.022. Epub 2014 Jan 11.
  2. Mammen AL. Autoimmune myopathies: autoantibodies, phenotypes and pathogenesis. Nat Rev Neurol. 2011; 7:343–354. [PubMed: 21654717]
  3. Betteridge ZE, Gunawardena H, McHugh NJ. Novel autoantibodies and clinical phenotypes in adult and juvenile myositis. Arthritis Res Ther. 2011; 13:209. [PubMed: 21457520]
  4. Rider LG, Shah M, Mamyrova G, Huber AM, Rice MM, Targoff IN, et al. The Myositis Autoantibody Phenotypes of the Juvenile Idiopathic Inflammatory Myopathies. Medicine (Baltimore ). 2013; 92:223–243. [PubMed: 23877355]
  5. Ghirardello A, Bassi N, Palma L, Borella E, Domeneghetti M, Punzi L, et al. Autoantibodies in polymyositis and dermatomyositis. Curr Rheumatol Rep. 2013; 15:335–0335. [PubMed: 23591825]
  6. Koenig M, Fritzler MJ, Targoff IN, Troyanov Y, Senecal JL. Heterogeneity of autoantibodies in 100 patients with autoimmune myositis: insights into clinical features and outcomes. Arthritis Res Ther. 2007; 9:R78. [PubMed: 17688695]
  7. Mahler M, Fritzler MJ. Epitope specificity and significance in systemic autoimmune diseases. Ann N Y Acad Sci. 2010; 1183:267–287. [PubMed: 20146721]
  8. Polymyositis/Dermatomyositis.  The Free Online Rheumatology Textbook. Retrieved from
  9. Mirrakhimov AE1. Antisynthetase syndrome: a review of etiopathogenesis, diagnosis and management.Curr Med Chem. 2015;22(16):1963-75.
  10. Chatterjee S1, Prayson R, Farver C. Antisynthetase syndrome: not just an inflammatory myopathy. Cleve Clin J Med. 2013 Oct;80(10):655-66. doi: 10.3949/ccjm.80a.12171.
  11. Malik A1, Hayat G1, Kalia JS2, Guzman MA3. Idiopathic Inflammatory Myopathies: Clinical Approach and Management. Front Neurol. 2016 May 20;7:64. doi: 10.3389/fneur.2016.00064. eCollection 2016.
  12. Witt LJ1, Curran JJ2, Strek ME1. The Diagnosis and Treatment of Antisynthetase Syndrome. Clin Pulm Med. 2016 Sep;23(5):218-226.
  13. Hartleb M, Gutkowski K, Milkiewicz P.Nodular regenerative hyperplasia: evolving concepts on underdiagnosed cause of portal hypertension. World J Gastroenterol. 2011 Mar 21;17(11):1400-9. doi: 10.3748/wjg.v17.i11.1400.

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International Journal of Biomedicine. 2017;7(2):141-143. ©2017 International Medical Research and Development Corporation. All rights reserved.