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Antisynthetase syndrome — SCE Rheumatology MCQ

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HardConnective tissue diseasesAntisynthetase syndromeSCE Rheumatology

A 36-year-old mechanic has proximal muscle weakness, mechanic's hands and inflammatory arthritis. CK is 4,800 IU/L, ANA is positive, anti-Jo-1 antibody is positive and HRCT shows organising pneumonia. What is the most likely diagnosis?

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Correct answer: C — Antisynthetase syndrome

Anti-Jo-1, mechanic's hands, myositis, arthritis and ILD form antisynthetase syndrome. Inclusion body myositis tends to affect older men with finger flexor and quadriceps weakness and does not explain ILD or anti-Jo-1. Recognising the syndrome matters because lung disease often drives prognosis and treatment intensity.

Reference: BSR idiopathic inflammatory myopathy guideline 2022; EULAR myositis recommendations