BACKGROUND This study presents a case of rapidly developing respiratory failure due to antisynthetase syndrome(AS)following coronavirus disease 2019(COVID-19)in a 33-year-old man diagnosed with Klinefelter syndrome(KS...BACKGROUND This study presents a case of rapidly developing respiratory failure due to antisynthetase syndrome(AS)following coronavirus disease 2019(COVID-19)in a 33-year-old man diagnosed with Klinefelter syndrome(KS).CASE SUMMARY A 33-year-old man with a diagnosis of KS was admitted to the Department of Pulmonary and Critical Care Medicine of a tertiary hospital in China for fever and shortness of breath 2 wk after the onset of COVID-19.Computed tomography of both lungs revealed diffuse multiple patchy heightened shadows in both lungs,accompanied by signs of partial bronchial inflation.Metagenomic next-generation sequencing of the bronchoalveolar lavage fluid suggested absence of pathogen.A biopsy specimen revealed organizing pneumonia with alveolar septal thickening.Additionally,extensive auto-antibody tests showed strong positivity for anti-SSA,anti-SSB,anti-Jo-1,and anti-Ro-52.Following multidisciplinary discussions,the patient received a final diagnosis of AS,leading to rapidly progressing respiratory failure.CONCLUSION This study underscores the clinical progression of AS-associated interstitial lung disease subsequent to viral infections such as COVID-19 in patients diagnosed with KS.展开更多
目的分析研究多发性肌炎(polymyositis,PM)患者抗PM-SCL抗体、抗Jo-1抗体、血清涎液化糖链抗原(Krebs von den Lungen-6,KL-6)表达与合并肺间质疾病(interstitial lung disease,ILD)的关系。方法选取2020年2月到2023年2月开封市中心医...目的分析研究多发性肌炎(polymyositis,PM)患者抗PM-SCL抗体、抗Jo-1抗体、血清涎液化糖链抗原(Krebs von den Lungen-6,KL-6)表达与合并肺间质疾病(interstitial lung disease,ILD)的关系。方法选取2020年2月到2023年2月开封市中心医院收治的PM患者81例,根据是否合并肺间质疾病分为PM组(n=48)和PM合并ILD组(n=33)。比较两组一般资料、抗PM-SCL抗体、抗Jo-1抗体阳性率和血清KL-6表达情况,采用Spearman和Pearson相关检验分析抗PM-SCL抗体、抗Jo-1抗体、血清KL-6表达与HRCT评分的关系,采用多因素logistic回归分析影响PM合并ILD的危险因素,通过受试者工作特征(ROC)曲线评估血清KL-6对PM合并ILD的预测价值。结果PM合并ILD组年龄、咳嗽咳痰比例、胸闷憋喘比例、MYOACT评分、HRCT评分均显著高于PM组(P<0.05);PM合并ILD组抗PM-SCL抗体、抗Jo-1抗体阳性率和血清KL-6表达均显著高于PM组(P<0.05);相关检验结果显示,PM合并ILD患者抗PM-SCL抗体、抗Jo-1抗体、血清KL-6表达与HRCT评分呈显著正相关(P<0.05);多因素logistic回归分析显示,年龄、MYOACT评分、抗PM-SCL抗体、抗Jo-1抗体、血清KL-6是影响PM合并ILD的危险因素(P<0.05);ROC诊断曲线结果显示,以678.92 U/mL为最佳截点值,KL-6预测PM合并ILD的敏感度为87.88%,特异度为91.67%,曲线下面积为0.916(95%CI:0.843~0.989)。结论抗PM-SCL抗体、抗Jo-1抗体阳性以及血清KL-6表达上升是影响PM合并ILD的危险因素,通过检测血清KL-6表达并结合抗PM-SCL抗体、抗Jo-1抗体状态对PM合并ILD具有一定的预测价值。展开更多
基金Supported by the Natural Science Foundation of Jiangxi Province,No.20202BAB206002 and No.20224BAB216084.
文摘BACKGROUND This study presents a case of rapidly developing respiratory failure due to antisynthetase syndrome(AS)following coronavirus disease 2019(COVID-19)in a 33-year-old man diagnosed with Klinefelter syndrome(KS).CASE SUMMARY A 33-year-old man with a diagnosis of KS was admitted to the Department of Pulmonary and Critical Care Medicine of a tertiary hospital in China for fever and shortness of breath 2 wk after the onset of COVID-19.Computed tomography of both lungs revealed diffuse multiple patchy heightened shadows in both lungs,accompanied by signs of partial bronchial inflation.Metagenomic next-generation sequencing of the bronchoalveolar lavage fluid suggested absence of pathogen.A biopsy specimen revealed organizing pneumonia with alveolar septal thickening.Additionally,extensive auto-antibody tests showed strong positivity for anti-SSA,anti-SSB,anti-Jo-1,and anti-Ro-52.Following multidisciplinary discussions,the patient received a final diagnosis of AS,leading to rapidly progressing respiratory failure.CONCLUSION This study underscores the clinical progression of AS-associated interstitial lung disease subsequent to viral infections such as COVID-19 in patients diagnosed with KS.
文摘目的分析研究多发性肌炎(polymyositis,PM)患者抗PM-SCL抗体、抗Jo-1抗体、血清涎液化糖链抗原(Krebs von den Lungen-6,KL-6)表达与合并肺间质疾病(interstitial lung disease,ILD)的关系。方法选取2020年2月到2023年2月开封市中心医院收治的PM患者81例,根据是否合并肺间质疾病分为PM组(n=48)和PM合并ILD组(n=33)。比较两组一般资料、抗PM-SCL抗体、抗Jo-1抗体阳性率和血清KL-6表达情况,采用Spearman和Pearson相关检验分析抗PM-SCL抗体、抗Jo-1抗体、血清KL-6表达与HRCT评分的关系,采用多因素logistic回归分析影响PM合并ILD的危险因素,通过受试者工作特征(ROC)曲线评估血清KL-6对PM合并ILD的预测价值。结果PM合并ILD组年龄、咳嗽咳痰比例、胸闷憋喘比例、MYOACT评分、HRCT评分均显著高于PM组(P<0.05);PM合并ILD组抗PM-SCL抗体、抗Jo-1抗体阳性率和血清KL-6表达均显著高于PM组(P<0.05);相关检验结果显示,PM合并ILD患者抗PM-SCL抗体、抗Jo-1抗体、血清KL-6表达与HRCT评分呈显著正相关(P<0.05);多因素logistic回归分析显示,年龄、MYOACT评分、抗PM-SCL抗体、抗Jo-1抗体、血清KL-6是影响PM合并ILD的危险因素(P<0.05);ROC诊断曲线结果显示,以678.92 U/mL为最佳截点值,KL-6预测PM合并ILD的敏感度为87.88%,特异度为91.67%,曲线下面积为0.916(95%CI:0.843~0.989)。结论抗PM-SCL抗体、抗Jo-1抗体阳性以及血清KL-6表达上升是影响PM合并ILD的危险因素,通过检测血清KL-6表达并结合抗PM-SCL抗体、抗Jo-1抗体状态对PM合并ILD具有一定的预测价值。
