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Anasarca as the first presentation of anti-synthetase syndrome
  1. Jiaqing Xiong1,
  2. Tharmmambal Balakrishnan1 and
  3. Warren Fong2,3,4
  1. 1 Department of Internal Medicine, Singapore General Hospital, Singapore
  2. 2 Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
  3. 3 Office of Education, Duke-NUS Graduate Medical School, Singapore
  4. 4 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  1. Correspondence to Dr Jiaqing Xiong; xuanjvquan{at}


A woman in her 70s presented with anasarca and exertional dyspnoea. Investigation showed severe hypoalbuminaemia with no urinary or gastrointestinal protein losses. CT thorax reported lung consolidations, and transbronchial lung biopsy demonstrated organising pneumonia. Autoimmune myositis serology was positive for anti-Jo-1, anti-Ro-52, and anti-PM/Scl-100 antibodies. She was diagnosed with anti-synthetase syndrome with organising pneumonia. She was treated with oral prednisolone and oral mycophenolate mofetil with a good clinical response.

  • Rheumatology
  • Connective tissue disease

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  • Contributors JX was responsible for drafting of the text, sourcing and editing of clinical images and investigation results. TB and WF provided critical revision for important intellectual content. All three authors were involved in the patient’s care. The following authors gave final approval of the manuscript: JX, TB and WF.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.