Anti‐synthetase syndrome complicated by multifocal tuberculosis: A thought‐provoking differential diagnosis with tumors

• Published in: Medicine advances (Online) 2024-09, Vol.2 (3), p.312-317
• Main Authors: Dai, Chang, Jiang, Yu, Lin, Weidong, Chen, Yuhan, Liu, Fangzhou, Deng, Hai, Chen, Yanlin, Chen, Haowei, Wang, Jieying, Lei, Yunxia, Wu, Shulin, Xue, Yumei
• Format: Article
• Language: English
• Subjects: anti‐synthetase syndrome; diagnosis; tuberculosis; tumor
• ISSN: 2834-4391; 2834-4405
• DOI: 10.1002/med4.78

Mycobacterium tuberculosis, which mainly affects the lungs but can also invade other systems, presents a diagnostic challenge when co‐existing with autoimmune disease. We report a case of 31‐year‐old Asian woman with anti‐synthetase syndrome who developed abdominal and subcutaneous lumps during treatment, along with elevated tumor markers, raising suspicion of malignancy. Pathological examination revealed M. tuberculosis infection, changing the diagnosis to multifocal extrapulmonary tuberculosis. This case highlights the need for prompt and detailed evaluations, and the importance of broad differential diagnosis. A 31‐year‐old woman with anti‐synthetase syndrome developed abdominal and subcutaneous lumps during immunosuppressive treatment, with elevated tumor markers suggesting malignancy. Pathological examination revealed Mycobacterium tuberculosis, leading to a revised diagnosis of multifocal extrapulmonary tuberculosis. Targeted therapy improved her condition. This case underscores the necessity of thorough pathological evaluations and broad differential diagnosis in patients with overlapping infectious and autoimmune symptoms.