# Anti-Synthetase Syndrome: A Case Report on the Elevated Risk of Pneumocystosis

## TL;DR

This case report highlights a 58-year-old patient with anti-synthetase syndrome who developed Pneumocystis jirovecii pneumonia, showing the risk of pneumocystosis in immunocompromised individuals.

## Contribution

The report emphasizes the elevated risk of pneumocystosis in patients with anti-synthetase syndrome and interstitial lung disease.

## Key findings

- The patient exhibited symptoms of PJP along with anti-JO-1 antibodies and interstitial lung disease.
- PJP was confirmed through bronchoalveolar lavage despite no prior AIDS diagnosis.
- The case underscores the need for vigilance in immunocompromised patients beyond AIDS.

## Abstract

Pneumocystis carinii pneumonia (PCP), now referred to as Pneumocystis jirovecii pneumonia (PJP), occurs in immunocompromised patients. It is particularly associated with cellular immunodeficiency due to certain diseases or treatments. The risk of PCP is likely correlated with the severity of cellular immunity damage. However, excluding AIDS, the precise degree of immunosuppression required to develop PCP is not yet clearly understood.

We report the case of a 58-year-old patient who presented with progressively worsening dyspnea. The clinical examination revealed a SaO₂ of 88% on room air and the appearance of mechanic's hands. A thoracic CT scan showed interstitial lung disease (ILD). The immunological work-up was positive for antinuclear antibodies (ANA) and anti-JO-1 antibodies. Bronchoscopy with bronchoalveolar lavage (BAL) was performed, and the test for PJP came back positive.