Anti-OJ antibody-positive anti-synthetase syndrome associated with hepatocellular carcinoma.
Kisaki Tachi, Makoto Kita, Rie Kawakita et al.
✦ AI-curated · Sources linked
Case in brief
A man in his 70s with hepatocellular carcinoma presented with progressive proximal muscle weakness and dropped head syndrome. Investigations showed elevated creatine kinase, abnormal muscle imaging, and myopathic changes. Although conventional serology was negative, advanced testing confirmed anti-OJ positivity. After hepatic lobectomy, the patient's muscle weakness and laboratory abnormalities improved without the need for immunotherapy.
What made this case unusual
The case highlights the association of anti-OJ-positive anti-synthetase syndrome with hepatocellular carcinoma, which is rarely reported and often underdiagnosed due to false-negative results in conventional assays.
Diagnostic / clinical pearl
Clinicians should consider advanced serological testing for anti-OJ antibodies in patients with unexplained muscle weakness, especially when conventional assays yield negative results.
Why it matters
This case underscores the potential for tumor resection to lead to remission of paraneoplastic syndromes, emphasizing the importance of addressing underlying malignancies in such patients.