Pneumomediastinum complicating the anti-synthetase syndrome

Introduction: Pneumomediastinum is a rare but classical complication of dermatomyositis. Its development is a serious matter and necessitates prompt recourse to aggressive treatment with corticosteroids combined with immuno-suppressants or intravenous human immunoglobulin. Case report: We report the case of a 63 year old woman presenting with pulmonary infiltration, in the presence of dermatomyositis, as a clinical manifestation of the anti-synthetase syndrome. The progress was rapidly unfavourable with pneumomediastinum and acute respiratory distress despite initial treatment with corticosteroids followed by human immunoglobulin and immunosuppressants. Conclusion: The identification of cutaneous or muscular signs in the initial investigation of a pulmonary infiltrate should lead to a search for anti-synthetase antibodies in order to determine the optimal clinical management as quickly as possible.