An amyopathic presentation of anti-PL-7 antisynthetase syndrome

Anti-PL 7 anti-synthetase syndrome (ASS) is a rare cause of interstitial lung disease (ILD). A 52-year-old woman presented with worsening dyspnoea and exertional desaturation after a flu-like episode without any evidence of muscle involvement. She had a skin rash diagnosed as pemphigus foliaceus but had no evidence of cutaneous manifestations of ASS. Her HRCT scan of the chest showed fibrotic ILD. Anti-PL-7 antibody and anti-Ro-52 were positive in the myositis antibody panel. She was treated with immunosuppressants for which she showed a rapid response. In patients presenting with worsening respiratory symptoms mimicking infection, ILD should be considered together with secondary causes of ILD including ASS even in the absence of clinical features of ASS or myositis.