Antisynthetase syndrome is a type of Idiopathic Inflammatory Myopathy (IIM) associated with anti-Jo1 antibody. Kennedy’s disease
or X-linked spinal and bulbar muscular atrophy (SBMA) is a rare neuromuscular disease. We describe the case report of a 53-year-old
man who presented with proximal muscle weakness and a history of bilateral hand tremor. Initial physical examination demonstrated
“mechanic’s hands”, Raynaud’s phenomenon, having elevated creatine kinase and lactate dehydrogenase levels and anti-Jo1 antibody
positivity. His muscle biopsy demonstrated inflammatory infiltrate characteristic of IIM. Considering these findings, we reached
the diagnosis of antisynthetase syndrome and commenced immunosuppressive therapy. On follow-up examination, he had developed
dysphagia, and his tremor had worsened. His electroneurogram result was characteristic of Kennedy’s disease, and the genetic
test result showed an allele with 44 CAG repeat expansion in the androgen receptor gene of the X chromosome. This confirmed
that in addition to antisynthetase syndrome, he also had Kennedy’s disease. This patient now receives immunology and neurology
follow-up. His symptoms have improved with low dose corticosteroids, propranolol for tremor, vitamin B supplementation, and
physiotherapy. This article presents a rare case report of a patient with concurrent antisynthetase syndrome and Kennedy’s
disease, both of which lead to elevated creatine kinase levels and muscle weakness, thus, underpinning the importance of careful
follow-up of patients with IIM and maintaining an open mind to other diagnoses when faced with refractory and/or new symptoms.
Keywords Antisynthetase syndrome - Idiopathic Inflammatory Myopathy - Kennedy’s disease - Spinal and bulbar muscular atrophy