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Anti-Synthetase Syndrome — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardConnective Tissue & VasculitisAnti-Synthetase SyndromeSCE Dermatology

A patient has mechanic hands, Raynaud phenomenon, inflammatory polyarthritis, proximal weakness and NSIP-pattern interstitial lung disease. Which antibody most directly unifies this phenotype?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Anti-Jo-1 directed against histidyl-transfer-RNA synthetase

Explanation lettering: E = shown as A · D = shown as C · A = shown as D · C = shown as E

B is correct. Mechanic hands, Raynaud phenomenon, non-erosive inflammatory arthritis, myositis and interstitial lung disease form the antisynthetase phenotype. Anti-Jo-1 targets histidyl-tRNA synthetase and is the most frequently detected antisynthetase antibody. Anti-SRP is associated with immune-mediated necrotising myopathy, anti-TIF1-gamma with malignancy-associated adult dermatomyositis, anti-Mi-2 with classic cutaneous dermatomyositis and a generally lower ILD risk, while anti-MDA5 more often accompanies clinically amyopathic disease and rapidly progressive ILD. Antibody results must be interpreted with the clinical phenotype and should prompt pulmonary function and multidisciplinary ILD assessment.

Reference: BSR idiopathic inflammatory myopathy guideline: https://academic.oup.com/rheumatology/article/61/5/1760/6555980