In a patient with newly diagnosed with antisynthetase syndrome without clinical myositis who presents with organizing pneumonia and improves on high-dose corticosteroids, what factors should guide the selection of long-term immunosuppressive therapy?

Additionally, how common is diffuse hilar, axillary, or mediastinal lymphadenopathy seen in antisynthetase syndrome and can a reactive pattern on transbronchial biopsy reliably exclude alternative etiologies?

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In a patient with newly diagnosed with antisynthetase syndrome without clinical myositis who presents with organizing pneumonia and improves on high-dose corticosteroids, what factors should guide the selection of long-term immunosuppressive therapy?

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