Sunil Kumar

Antisynthetase syndrome (ASS) is a rare, chronic autoimmune disease and is a sub-group of idiopathic inflammatory myopathies. The hallmark of this disorder is the presence of autoantibodies against the aminoacyl-transfer ribonucleic acid (tRNA) synthetase. Patient presents with fever, exanthema on the hands (also referred to as mechanic’s hands), myositis, and/or interstitial lung disease (ILD), and/or articular involvement. Nearly 70% of patients with ASS presents with signs and symptoms of ILD. We are reporting a case of patient who was having ILD, who turned out to have ASS on further workup. ASS as causal diagnosis is missed many a times. As early and exact diagnosis has crucial therapeutic and prognostic implication, knowledge about this syndrome and high level of suspicion is of utmost importance.

Amyloidosis is a clinical disorder caused by extracellular and/or intracellular deposition of insoluble abnormal amyloid fibrils that alter the normal function of the tissues. Their clinical presentations consists of peripheral neuropathy, hepatomegaly, nephrotic syndrome, restrictive cardiomyopathy, purpura and other skin manifestations, bleeding diathesis and pleural effusion. Kidneys are the most common organs affected by primary amyloidosis. They present with swelling over ankles, feet, legs, fatigue, shortness of breath, weight loss, numbness in hand and feet but rarely present with unilateral significant pleural effusion. Similarly, we report a 58 years old male who presented with generalised weakness and fatiguability, lower limb edema and shortness of breath on exertion. Patient after being diagnosed as renal amyloidosis, was discharged and on follow up presented with unilateral left sided significant pleural effusion.