How do you approach management and monitoring of a patient with features suggestive of early or incomplete antisynthetase syndrome (mechanics hands and positive antisynthetase antibody) but no objective evidence of myositis, arthritis, or ILD at presentation?

Anti-Ha is a very rare antibody, and its positive predictive value is low, particularly when relying on line blot or multiplex bead assays. Especially in the setting of a high ANA titer, a low-level anti-Ha signal may represent cross-reactivity or a false positive, as anti-Ha antibodies are cytoplas...