Clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome: a case report and literature review
ObjectiveThe coexistence of psoriatic arthritis (PsA) with inflammatory myopathies, including antisynthetase syndrome (ASS), is exceptionally rare and presents significant diagnostic and therapeutic challenges. This study reports a case of PsA overlapping with ASS and reviews the literature to analy...
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| Language: | English |
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1626226/full |
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| author | Rui Yan Dan Ke Yan Zhang Li Li Yanying Liu Shengguang Li Xiaomin Liu |
| author_facet | Rui Yan Dan Ke Yan Zhang Li Li Yanying Liu Shengguang Li Xiaomin Liu |
| author_sort | Rui Yan |
| collection | DOAJ |
| description | ObjectiveThe coexistence of psoriatic arthritis (PsA) with inflammatory myopathies, including antisynthetase syndrome (ASS), is exceptionally rare and presents significant diagnostic and therapeutic challenges. This study reports a case of PsA overlapping with ASS and reviews the literature to analyze clinical features, immunopathogenesis, and treatment strategies.MethodsA 52-year-old female with a 10-year history of psoriasis developed PsA and later presented with muscle weakness, mechanic’s hands, and interstitial lung disease (ILD). Serological testing revealed anti-Jo-1 and anti-SSA/Ro52 positivity, confirming ASS. We compare our case with 17 previously reported cases of psoriasis or PsA coexisting with inflammatory myopathies, highlighting similarities and differences in clinical presentation and treatment response.ResultsPsoriasis and inflammatory myopathies share immunopathogenic pathways, including the IL-17/IL-23 axis, type I interferons, and TNF-α. Therapies effective for psoriasis/PsA, such as TNF and IL-17 inhibitors, may exacerbate inflammatory myopathies, while JAK inhibitors and corticosteroids appear more effective in managing overlap cases. Our patient achieved sustained remission with baricitinib and low-dose prednisone after multiple treatment adjustments.ConclusionPsA and inflammatory myopathies can coexist, requiring careful differentiation and tailored immunomodulatory therapy. Clinicians should recognize overlapping features and optimize treatment to prevent exacerbations. Further research is needed to establish standardized management strategies for this rare overlap syndrome. |
| format | Article |
| id | doaj-art-8d41a76f16cf469ba50c69c6fa4a6a9f |
| institution | Kabale University |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-8d41a76f16cf469ba50c69c6fa4a6a9f2025-08-20T03:39:18ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.16262261626226Clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome: a case report and literature reviewRui Yan0Dan Ke1Yan Zhang2Li Li3Yanying Liu4Shengguang Li5Xiaomin Liu6Department of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, ChinaDepartment of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, ChinaDepartment of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, ChinaDepartment of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, ChinaDepartment of Rheumatology and Immunology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaDepartment of Rheumatology and Immunology, Peking University International Hospital, Beijing, ChinaDepartment of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, ChinaObjectiveThe coexistence of psoriatic arthritis (PsA) with inflammatory myopathies, including antisynthetase syndrome (ASS), is exceptionally rare and presents significant diagnostic and therapeutic challenges. This study reports a case of PsA overlapping with ASS and reviews the literature to analyze clinical features, immunopathogenesis, and treatment strategies.MethodsA 52-year-old female with a 10-year history of psoriasis developed PsA and later presented with muscle weakness, mechanic’s hands, and interstitial lung disease (ILD). Serological testing revealed anti-Jo-1 and anti-SSA/Ro52 positivity, confirming ASS. We compare our case with 17 previously reported cases of psoriasis or PsA coexisting with inflammatory myopathies, highlighting similarities and differences in clinical presentation and treatment response.ResultsPsoriasis and inflammatory myopathies share immunopathogenic pathways, including the IL-17/IL-23 axis, type I interferons, and TNF-α. Therapies effective for psoriasis/PsA, such as TNF and IL-17 inhibitors, may exacerbate inflammatory myopathies, while JAK inhibitors and corticosteroids appear more effective in managing overlap cases. Our patient achieved sustained remission with baricitinib and low-dose prednisone after multiple treatment adjustments.ConclusionPsA and inflammatory myopathies can coexist, requiring careful differentiation and tailored immunomodulatory therapy. Clinicians should recognize overlapping features and optimize treatment to prevent exacerbations. Further research is needed to establish standardized management strategies for this rare overlap syndrome.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1626226/fullpsoriatic arthritisantisynthetase syndromeJAK inhibitorsTNF inhibitorscase report |
| spellingShingle | Rui Yan Dan Ke Yan Zhang Li Li Yanying Liu Shengguang Li Xiaomin Liu Clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome: a case report and literature review Frontiers in Immunology psoriatic arthritis antisynthetase syndrome JAK inhibitors TNF inhibitors case report |
| title | Clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome: a case report and literature review |
| title_full | Clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome: a case report and literature review |
| title_fullStr | Clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome: a case report and literature review |
| title_full_unstemmed | Clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome: a case report and literature review |
| title_short | Clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome: a case report and literature review |
| title_sort | clinical features and therapeutic challenges of psoriatic arthritis coexisting with antisynthetase syndrome a case report and literature review |
| topic | psoriatic arthritis antisynthetase syndrome JAK inhibitors TNF inhibitors case report |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1626226/full |
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