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Antisynthetase syndrome-associated ILD — SCE Respiratory MCQ

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HardILDAntisynthetase syndrome-associated ILDSCE Respiratory

A 47-year-old man has mechanic's hands, proximal muscle weakness and Raynaud's phenomenon. CK is 2,300 IU/L. HRCT shows basal ground-glass change and reticulation; spirometry is restrictive with TLCO 44% predicted. What is the most likely diagnosis?

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Correct answer: C — Antisynthetase syndrome-associated ILD

Mechanic's hands, myositis, Raynaud's and ILD strongly suggest antisynthetase syndrome-associated ILD. IPF would not explain myositis and mechanic's hands. Langerhans cell histiocytosis is smoking-related with upper-zone nodules and cysts rather than autoimmune myositis features.

Reference: ERS/EULAR CTD-ILD Guidance; BTS ILD Guidance