CTICasesAnti-synthetase syndrome with acute fulminant lung injury
Imaging findings
CT scan of a 31-year-old previously healthy male demonstrates bilateral, dependent-predominant nodular and perilobular consolidation with reversed halos. Over several days, it progressed to diffuse ground-glass opacities, traction bronchiectasis, and pneumomediastinum, consistent with diffuse alveolar damage (DAD). Serology was positive for anti-Jo1 and anti-SSA.
Key takeaways
Anti-synthetase syndrome can present as an acute, fulminant interstitial lung injury (DAD/AIP pattern) that mimics infectious pneumonia. Perilobular consolidation and the reversed halo sign are key clues for an organizing pneumonia-like pattern associated with autoimmune myopathies.
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