CASE REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1626226
Clinical Features and Therapeutic Challenges of Psoriatic Arthritis Coexisting with Antisynthetase Syndrome: a case report and literature review
Provisionally accepted
- 1Capital Medical University, Beijing, China
- 2Peking University International Hospital, Beijing, China
- 3Beijing Shunyi Hospital, Beijing, China
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Objective: The coexistence of psoriatic arthritis (PsA) with inflammatory myopathies, including antisynthetase syndrome (ASS), and other inflammatory myopathies, 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.Methods: A 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.Results: Psoriasis 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.PsA 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.
Keywords: psoriatic arthritis, Antisynthetase syndrome, JAK inhibitors, TNF inhibitors, case report
Received: 10 May 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Yan, Ke, Zhang, Li, Liu, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Rui Yan, Capital Medical University, Beijing, China
Sheng-Guang Li, Peking University International Hospital, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.