SHM Converge Scientific Abstract ePoster Gallery-Anti-Synthetase Syndrome Presenting as Interstitial Lung Disease: A Case of Anchor Bias During Covid-19 Pandemic

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This case describes a 35-year-old woman with tobacco use who had three months of recurrent fever, dry cough, and exertional shortness of breath. She was initially treated for strep throat and later repeatedly managed as presumed COVID-19 pneumonia because of persistent respiratory symptoms and chest X-ray opacities, despite negative COVID PCR tests and no improvement. On evaluation, she was febrile, tachycardic, hypoxic, and had bilateral lung crackles. CT angiography showed extensive mixed reticular and airspace opacities with organizing pneumonia and fibrotic interstitial lung disease features. Infectious workup, including bronchoscopy and bronchoalveolar lavage, was negative.<br /><br />Further testing revealed mildly elevated CRP, weakly positive SSA antibody, negative anti-Jo-1, and positive anti-PL-12 antibody. Pulmonary function tests showed severe restriction and markedly reduced diffusion capacity. Although she lacked joint pain or muscle weakness, she was diagnosed with anti-synthetase syndrome presenting as interstitial lung disease. She was started on prednisone and mycophenolate mofetil, with subsequent symptomatic improvement and stable oxygen needs.<br /><br />The report emphasizes that anti-synthetase syndrome can present primarily with ILD, especially in anti-PL-12–positive patients, and that ILD can closely mimic COVID-19 pneumonia on clinical and radiographic grounds. The authors highlight the importance of maintaining a broad differential diagnosis in hypoxic respiratory failure and avoiding anchoring bias, particularly during the COVID-19 pandemic.

Asset Subtitle

Harris Majeed

Meta Tag

Author List Abu Baker Sheikh, Chanhwa Hong, Harris Majeed

Category Clinical Vignettes

Concept Antisynthetase Syndrome

Concept Interstitial Lung Disease

Concept Hypoxemic Respiratory Failure

Concept Anti-PL12 Antibody

Concept Autoantibody

Distinguished Non-Finalist

Presenter Organization UNM Hospital

Presenting Author Harris Majeed

Track Adult

Keywords

anti-synthetase syndrome

interstitial lung disease

anti-PL-12 antibody

organizing pneumonia

fibrotic lung disease

COVID-19 mimic

hypoxic respiratory failure

mycophenolate mofetil

prednisone therapy

bronchoalveolar lavage

Antisynthetase Syndrome

Interstitial Lung Disease

Hypoxemic Respiratory Failure

Anti-PL12 Antibody

Autoantibody