{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T23:22:16Z","timestamp":1767136936559,"version":"build-2238731810"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Key Clinical Message<\/jats:title>\n                    <jats:p>Acute digital ischemia is a rare manifestation of anti\u2010synthetase syndrome in the absence of Raynaud's phenomenon. A high index of suspicion may result in early diagnosis and better clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>A 61\u2010year\u2010old male patient was admitted to the hospital for worsening arthralgias with morning stiffness lasting hours, as well as left sided headaches, and jaw pain while eating. He had significant weight loss and subjective fever at home. Multiple fingers and toes were noted to be ischemic. His laboratory workup was pertinent for significantly elevated inflammatory markers, and mild Creatinine kinase elevation. Chest imaging and later lung biopsy were notable for organizing pneumonia. Conventional angiogram showed evidence of significant digital disease without collaterals. Subsequent autoimmune screening tests with extended myositis\u2010specific and myositis\u2010associated panels revealed a strongly positive anti\u2010PL\u201012 antibody and moderately positive anti\u2010 SSA\u201052KD IgG ab. After ruling out infectious etiologies and malignancy, anti\u2010synthetase syndrome (ASyS) diagnosis was considered in the presence of ischemic digits, organizing pneumonia, polyarthralgia, constitutional symptoms, increased inflammatory markers and positive antibodies. The patient was treated with high dose prednisone and mycophenolate mofetil along with amlodipine and sildenafil for digital vasodilation. Acute digital ischemia may be the first manifestation of ASyS with ILD. A high index of suspicion is warranted for early diagnosis and better outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccr3.9408","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T01:39:37Z","timestamp":1724895577000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Anti\u2010PL\u201012 anti\u2010synthetase syndrome manifesting with multiple digital ischemia: Case report &amp; review of the literature"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1914-7400","authenticated-orcid":false,"given":"Sarah Abi","family":"Doumeth","sequence":"first","affiliation":[{"name":"Department of Rheumatology Case Western Reserve University Hospitals  Cleveland Ohio USA"},{"name":"Department of Medicine Case Western Reserve University Hospitals  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Petrinec","sequence":"additional","affiliation":[{"name":"Department of Medicine Case Western Reserve University Hospitals  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haseeb","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Case Western Reserve University Hospitals  Cleveland Ohio USA"},{"name":"Department of Medicine Case Western Reserve University Hospitals  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Mattar","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Case Western Reserve University Hospitals  Cleveland Ohio USA"},{"name":"Department of Rheumatology Louis Stokes VA Medical Center  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,28]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Orphanet: Antisynthetase 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anti\u2010PL\u201012 antibody\u2010positive antisynthetase syndrome with recurrent digital ulcers","volume":"15","year":"2023","journal-title":"Accessed: Nov"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/BCR-2016-219111"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/RAI2.12035"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/S11926-015-0532-1"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/S13075-020-02412-8"},{"key":"e_1_2_12_20_1","unstructured":"Clinical characteristics of Japanese patients with anti\u2010PL\u20107 (anti\u2010threonyl\u2010tRNA synthetase) autoantibodies \u2010 PubMed.2023https:\/\/pubmed.ncbi.nlm.nih.gov\/16173235\/"},{"key":"e_1_2_12_21_1","doi-asserted-by":"crossref","unstructured":"YoshidaA GonoT OkazakiY ShiraiY TakenoM KuwanaM.Severe digital ischemia as an unrecognized manifestation in patients with antisynthetase autoantibodies: Case series and systematic literature 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