[Clinical characteristics of patients with antisynthetase syndrome and positive anti-Ro52 antibody].

To analyze the clinical characteristics of patients with antisynthetase syndrome (ASS) and positive anti-Ro52 antibody. The clinical data of 203 ASS patients admitted to the First Affiliated Hospital of Zhengzhou University from 2017 to 2020 were analyzed retrospectively. Demographics, clinical manifestations, laboratory results, treatment and outcome were collected including data of 18 patients with rapidly progressive interstitial lung disease (RP-ILD). In total, the majority were women (148,72.9%). The average onset age was (51.9±13.3) years. There were 163 (80.3%) patients with positive anti-Ro52 antibody. The positivity in women (77.3% vs. 55.0%, P=0.004) was higher, and the median time from disease onset to diagnosis [4.5 (2.0, 24.0) months vs. 2.0 (1.0, 12.0) months, P=0.024] was longer in patients with positive anti-Ro52 antibody than those negative. Compared with negative patients, patients with positive anti-Ro52 antibody had a higher incidence of interstitial lung disease (ILD) (96.9% vs. 65.0%, P<0.001), arthritis (33.7% vs. 17.5%, P=0.046), and arthralgia (39.3% vs. 20.0%, P=0.022). Higher rate of positve antinuclear antibody (ANA) (85.3% vs. 55.0%, P<0.001), lower rate of positive anti-Jo-1 antibody (32.5% vs. 50.0%, P=0.039), lower albumin level [(34.6±5.2) g/L vs. (37.3±4.7) g/L,P=0.004] and lower lymphocyte counts [(1.4±0.8) ×109/L vs. (1.8±0.8) ×109/L, P=0.014] were more common in patients with positive anti-Ro52 antibody. The presence of anti-Ro52 antibody is associated with a particular phenotype of ASS, leading to common ILD, involvement of joints, high ANA positivity, low albumin and low lymphocyte counts.

Atypical radiographic appearance and clinical presentation of pulmonary tuberculosis.

Fourteen patients with unusual presentation of pulmonary tuberculosis are described. Often, exposure to the tubercle bacillus was not apparent. In other cases, there was tuberculous infection or reactivation of a previous focus in individuals with altered immunity. The radiographic presentation often differed from the classic cavitating upper lobe disease. Persistent pneumonia, cavities, and nodules were seen in other areas of the lung including the anterior segments and the lung bases. Isolated effusion and solitary nodules were also evident. Increased suspicion of tuberculosis should be maintained when evaluating persistent parenchymal consolidation, effusion, and cavitating pulmonary disease.