Fulminant Respiratory Failure Caused by Anti-asparaginyl tRNA Synthetase (Anti-KS) Antibody Syndrome-related Interstitial Lung Disease

• Published in: Internal Medicine Vol. 61; no. 22; pp. 3409 - 3414
• Main Authors: Taniguchi, Akihiko, Mitani, Reo, Oda, Naohiro, Senoo, Satoru, Aokage, Toshiyuki, Takata, Ichiro, Nagashima, Kenta, Miyahara, Nobuaki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.11.2022; Japan Science and Technology Agency
• Subjects: Amino Acyl-tRNA Synthetases; Aminoacyl-tRNA ligase; anti-ARS antibody syndrome; anti-asparaginyl tRNA synthetase antibody; anti-KS antibody; Autoantibodies; Case Report; extracorporeal membrane oxygenation; Humans; Internal medicine; interstitial pneumonia; Lung diseases; Lung Diseases, Interstitial - complications; Lung Diseases, Interstitial - diagnosis; Myositis; Myositis - diagnosis; Oxygenation; Patients; Pneumonia; Respiratory Insufficiency - etiology; Respiratory Insufficiency - therapy; tRNA; anti-KS antibody; extracorporeal membrane oxygenation; anti-asparaginyl tRNA synthetase antibody; interstitial pneumonia; anti-ARS antibody syndrome
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.9239-21

Anti-asparaginyl transfer RNA (tRNA) synthetase (KS) antibodies, detected in <5% patients with anti-aminoacyl-tRNA synthetase antibody syndrome, are strongly associated with interstitial pneumonia but not myositis and skin symptoms. A recent report suggested that most patients with interstitial pneumonia and anti-KS antibody (KS-ILD) may present with chronic disease. We herein report a rare case of severe acute respiratory failure in a KS-ILD patient requiring extracorporeal membrane oxygenation (ECMO). ECMO is useful for facilitating not only lung rest until recovery but also the definitive diagnosis and treatment of ILD. KS-ILD can develop acutely with fulminant respiratory failure, as observed in this case.