cd /tmp/workspace/attachments/814c23c1-d709-4f90-ae2a-bbb92b171e62/ && for f in "first summary original.pdf" "first lab dec 2025.pdf" "final folow up.pdf"; do echo "=== $f"; python3 -c " import pdfplumber,sys with pdfplumber.open(sys.argv[1]) as p: print(len(p.pages),'pages') for pg in p.pages: print(pg.extract_text()) " "$f"; done

mkdir -p /tmp/workspace/jic2027 && cat > /tmp/workspace/jic2027/abstract.txt <<'EOF' Case History: A [XX]-year-old woman presented in December 2025 with intermittent back pain radiating to the hips and lower limbs, polyarthralgia with 30 minutes of morning stiffness, photosensitive malar rash, and high-grade fever recurring for 1 to 1.5 years. An outside hospital had diagnosed adult-onset Still's disease (AOSD) and given six cyclophosphamide doses (last on 18 November 2025) without remission. Rheumatoid factor and ANA-ELISA were negative. Diagnosis: Investigations showed neutrophilic leukocytosis (WBC 17.8 to 20.8 x10^3/µL), microcytic hypochromic anaemia (Hb 9.5 to 10.4 g/dL), ESR 66 mm/h, CRP 178 mg/L, ferritin 202 ng/mL, hypoalbuminaemia, and vitamin D deficiency. Anti-CCP, ANCA, HIV, hepatitis B and C, malaria, and Widal tests were negative. CPK was normal. ANA blot revealed anti-SSA, anti-SSB, and anti-Jo-1 antibodies, and thigh MRI suggested myositis. The non-elevated ferritin and this antibody profile favoured an autoimmune overlap with antisynthetase and Sjogren-spectrum features over AOSD. Management: She received methotrexate 20 mg weekly, hydroxychloroquine 200 mg daily, prednisolone 15 mg tapering to 10 mg, and short-course aceclofenac. For worsening joint and muscle pain, rituximab 500 mg (8 June 2026) and 1 g (24 June 2026) were given; a third 1 g dose is planned after 24 November 2026. Discussion: Fever, arthralgia, and leukocytosis with negative conventional serology can lead to an AOSD label, which is a diagnosis of exclusion. Extended autoantibody testing and imaging can redirect the diagnosis. Normal CPK does not exclude myositis, and MRI is a useful adjunct. Failure of cyclophosphamide should prompt diagnostic review. Rituximab is an accepted option in refractory antisynthetase syndrome and related myositis. Outcome: By October 2026, CRP fell from 111 to 50 mg/L and ESR from 64 to 19 mm/h compared with April 2026. CPK was 55 U/L, muscle power was 5/5 in all groups, and no joints were swollen. Residual myalgia, eight tender joints, anaemia (Hb 9.6 g/dL), and thrombocytosis persist; follow-up continues. EOF wc -w /tmp/workspace/jic2027/abstract.txt

cat > /tmp/workspace/jic2027/abstract.txt <<'EOF' Case History: A [XX]-year-old woman presented in December 2025 with intermittent back pain radiating to the hips and lower limbs, polyarthralgia with 30 minutes of morning stiffness, photosensitive malar rash, and high-grade fever recurring for 1 to 1.5 years. An outside hospital had diagnosed adult-onset Still's disease (AOSD) and given six cyclophosphamide doses (last on 18 November 2025) without remission. Rheumatoid factor and ANA-ELISA were negative. Diagnosis: Investigations showed neutrophilic leukocytosis (WBC up to 20.8 x10^3/µL), microcytic hypochromic anaemia (Hb 9.5 to 10.4 g/dL), ESR 66 mm/h, CRP 178 mg/L, ferritin 202 ng/mL, and hypoalbuminaemia. Anti-CCP, ANCA, HIV, hepatitis B and C, malaria, and Widal tests were negative. CPK was normal. ANA blot revealed anti-SSA, anti-SSB, and anti-Jo-1 antibodies, and thigh MRI suggested myositis. The non-elevated ferritin and this antibody profile favoured an autoimmune overlap with antisynthetase and Sjogren-spectrum features over AOSD. Management: She received methotrexate 20 mg weekly, hydroxychloroquine 200 mg daily, prednisolone 15 mg tapering to 10 mg, and short-course aceclofenac. For worsening joint and muscle pain, rituximab 500 mg (8 June 2026) and 1 g (24 June 2026) were given; a third 1 g dose is planned after 24 November 2026. Discussion: Fever, arthralgia, and leukocytosis with negative conventional serology can lead to an AOSD label, which is a diagnosis of exclusion. Extended autoantibody testing and imaging can redirect the diagnosis. Normal CPK does not exclude myositis, and MRI is a useful adjunct. Failure of cyclophosphamide should prompt diagnostic review. Rituximab is an accepted option in refractory antisynthetase syndrome. Outcome: By October 2026, CRP fell from 111 to 50 mg/L and ESR from 64 to 19 mm/h compared with April 2026. CPK was 55 U/L, muscle power was 5/5, and no joints were swollen. Residual myalgia, eight tender joints, anaemia, and thrombocytosis persist; follow-up continues. EOF wc -w /tmp/workspace/jic2027/abstract.txt

"antisynthetase syndrome" AND rituximab

antisynthetase syndrome India

"Still's Disease, Adult-Onset" AND "diagnosis, differential"

myositis MRI creatine kinase normal

myositis India autoantibodies

"anti-Jo-1" AND "anti-Ro52"

adult-onset Still's disease India

antisynthetase syndrome classification criteria

Indian Journal of Rheumatology antisynthetase syndrome Jo-1 India cohort

https://www.mjrheum.org/dec-2022/showreferences792/1/showful…

PMID: 27193471

PMID: 38890654

PMID: 41308819

PMID: 38895121

anti-Jo-1 antibody Indian patients interstitial lung disease myositis

mkdir -p /tmp/workspace/jic2027 && cat > /tmp/workspace/jic2027/make.py <<'EOF' from docx import Document from docx.shared import Pt, Inches from docx.enum.text import WD_ALIGN_PARAGRAPH from docx.oxml.ns import qn import re title = "Adult-Onset Still's Disease Mimic: Anti-Jo-1 and Anti-Ro52 Positive Overlap Myositis With Normal CPK Responding to Rituximab" sections = [ ("Case History", "A [XX]-year-old woman presented in December 2025 with intermittent back pain radiating to the hips and lower limbs, polyarthralgia with 30 minutes of morning stiffness, photosensitive malar rash, and high-grade fever recurring for 1 to 1.5 years. An outside hospital had diagnosed adult-onset Still's disease (AOSD) and given six cyclophosphamide doses (last on 18 November 2025) without remission. Rheumatoid factor and ANA-ELISA were negative."), ("Diagnosis", "Investigations showed neutrophilic leukocytosis (WBC up to 20.8 x10^3/µL), microcytic anaemia (Hb 9.5 to 10.4 g/dL), ESR 66 mm/h, CRP 178 mg/L, ferritin 202 ng/mL, and normal CPK. Anti-CCP, ANCA, and infection screens were negative. ANA blot showed anti-Jo-1, anti-Ro52/SSA, and anti-SSB antibodies. MRI of both thighs showed subtle STIR hyperintensity in the quadriceps, adductor, hamstring, sartorius, and gracilis muscles, without effusion or collection, indicating myositis. Normal ferritin and this serology favoured antisynthetase overlap over AOSD."), ("Management", "Methotrexate 20 mg weekly, hydroxychloroquine 200 mg daily, prednisolone 15 mg tapering to 10 mg, and short-course aceclofenac were prescribed. For worsening joint and muscle pain, rituximab 500 mg (8 June 2026) and 1 g (24 June 2026) were given. A third dose is planned after 24 November 2026."), ("Discussion", "Fever, arthralgia, and leukocytosis with negative conventional serology can wrongly suggest AOSD, a diagnosis of exclusion [1,2], also described in India [3,4]. Myositis-specific antibody testing identifies antisynthetase syndrome, and Indian series report anti-Jo-1 in a notable minority of myositis and interstitial lung disease patients [5-7]. Normal CPK does not exclude myositis, so MRI helps [8]. Coexisting anti-Ro52 defines a distinct phenotype [9]. Incomplete forms are missed without antibody testing [12,13]. Rituximab is an established option in refractory disease [10,11]."), ("Outcome", "By October 2026, CRP fell from 111 to 50 mg/L and ESR from 64 to 19 mm/h. CPK was 55 U/L, muscle power 5/5, and no joints were swollen. Myalgia, eight tender joints, anaemia, and thrombocytosis persist. Follow-up continues."), ] refs = [ "Grami N, Budhram DR, Gold WL. Adult-onset Still disease. CMAJ. 2025. doi:10.1503/cmaj.241321", "Tada Y, Maruyama A, Shirahama Y, et al. Still's disease onset in older adults: clinical features, diagnosis, and management. Drugs Aging. 2024. doi:10.1007/s40266-024-01137-6", "Uppal SS, Pande IR, Kumar A. Adult onset Still's disease in northern India: comparison with juvenile onset Still's disease. Br J Rheumatol. 1995. doi:10.1093/rheumatology/34.5.429", "Singh YN, Adya CM, Kumar A, et al. Adult-onset Still's disease in India. Br J Rheumatol. 1992;31(6):417. doi:10.1093/rheumatology/31.6.417", "Srivastava P, Dwivedi S, Misra R. Myositis-specific and myositis-associated autoantibodies in Indian patients with inflammatory myositis. Rheumatol Int. 2016. doi:10.1007/s00296-016-3494-3", "Hegde A, et al. Anti-Jo1 syndrome: understanding a rare cause of interstitial lung disease. Mediterr J Rheumatol. 2022 (December issue; Indian single-centre series).", "Indu MB, et al. Prevalence of anti-synthetase syndrome in patients of interstitial lung disease with connective tissue diseases and autoimmune features: a cross-sectional study. Mediterr J Rheumatol. 2025;36(1). (Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India)", "Alhassan E. Normal creatine kinase does not exclude myositis nor indicate remission. Am J Med. 2026. doi:10.1016/j.amjmed.2025.11.012", "Yamaguchi K, Tang Q, Poland P, Reay DP, Gregory A, Aggarwal R. Clinical features associated with the presence of anti-Ro52 and anti-Ro60 antibodies in Jo-1 antibody-positive anti-synthetase syndrome. Front Immunol. 2024. doi:10.3389/fimmu.2024.1399451", "Narvaez J, Canadillas E, Castellvi I, et al. Rituximab in the treatment of progressive interstitial lung disease associated with the antisynthetase syndrome. Arthritis Res Ther. 2024. doi:10.1186/s13075-024-03353-2", "Langlois V, Gillibert A, Uzunhan Y, et al. Rituximab and cyclophosphamide in antisynthetase syndrome-related interstitial lung disease: an observational retrospective study. J Rheumatol. 2020. doi:10.3899/jrheum.190505", "Greco M, Garcia de Yebenes MJ, Alarcon I, et al. Idiopathic inflammatory myopathies and antisynthetase syndrome: contribution of antisynthetase antibodies to improve current classification criteria. Ann Rheum Dis. 2019. doi:10.1136/annrheumdis-2019-215031", "Aggarwal A, et al. Non-resolving pneumonia masquerading antisynthetase syndrome. Indian J Chest Dis Allied Sci. 2021;63. (case report, India)", ] body = " ".join(h+" "+t for h,t in sections) body_nocite = re.sub(r"\[[\d,\-]+\]", "", body) print("abstract words incl headings:", len(body_nocite.split()), "| excl headings:", len(" ".join(t for h,t in sections).replace("[XX]","XX").split())) doc = Document() for s in doc.sections: s.left_margin=s.right_margin=Inches(1); s.top_margin=s.bottom_margin=Inches(1) st = doc.styles["Normal"]; st.font.name="Times New Roman"; st.font.size=Pt(11) st.element.rPr.rFonts.set(qn("w:eastAsia"),"Times New Roman") def para(text="", bold=False, align=None, size=11, italic=False, after=6): p = doc.add_paragraph(); r = p.add_run(text); r.bold=bold; r.italic=italic r.font.name="Times New Roman"; r.font.size=Pt(size); r._element.rPr.rFonts.set(qn("w:eastAsia"),"Times New Roman") p.paragraph_format.space_after=Pt(after) if align: p.alignment=align return p para(title, bold=True, align=WD_ALIGN_PARAGRAPH.CENTER, size=12, after=10) para("Abstract (Clinical Case Study), JIC 2027", italic=True, align=WD_ALIGN_PARAGRAPH.CENTER, after=10) for h,t in sections: p = doc.add_paragraph(); p.alignment=WD_ALIGN_PARAGRAPH.JUSTIFY; p.paragraph_format.space_after=Pt(6) r = p.add_run(h+": "); r.bold=True r2 = p.add_run(t) for x in (r,r2): x.font.name="Times New Roman"; x.font.size=Pt(11); x._element.rPr.rFonts.set(qn("w:eastAsia"),"Times New Roman") para("Keywords: antisynthetase syndrome; anti-Jo-1; anti-Ro52; myositis; adult-onset Still's disease; rituximab", italic=True, after=12) para("References (not included in the 250 to 300 word abstract limit)", bold=True, after=4) for i,r in enumerate(refs,1): p = para(f"{i}. {r}", after=3); p.paragraph_format.left_indent=Inches(0.3); p.paragraph_format.first_line_indent=Inches(-0.3) f = doc.sections[0].footer.paragraphs[0]; f.alignment=WD_ALIGN_PARAGRAPH.CENTER fr = f.add_run("Poster presented at JIC 2027, Ahmedabad, India."); fr.font.name="Times New Roman"; fr.font.size=Pt(11); fr.bold=True doc.save("/tmp/workspace/jic2027/JIC2027_Case_Abstract.docx") EOF python3 /tmp/workspace/jic2027/make.py && ls -la /tmp/workspace/jic2027/

cd /tmp/workspace/jic2027 && python3 - <<'EOF' s = open('make.py').read() rep = [ (" Anti-CCP, ANCA, and infection screens were negative.", ""), (", without effusion or collection, indicating myositis", ", indicating myositis"), ("200 mg daily,", "200 mg,"), ("Myositis-specific antibody testing identifies antisynthetase syndrome, and Indian series report anti-Jo-1 in a notable minority of myositis and interstitial lung disease patients [5-7]. Normal CPK does not exclude myositis, so MRI helps [8]. Coexisting anti-Ro52 defines a distinct phenotype [9]. Incomplete forms are missed without antibody testing [12,13]. Rituximab is an established option in refractory disease [10,11].", "Indian series report anti-Jo-1 in a notable minority of myositis and interstitial lung disease patients [5-7]. Antibody testing also identifies incomplete antisynthetase syndrome [8,9]. Normal CPK does not exclude myositis, so MRI helps [10]. Coexisting anti-Ro52 defines a distinct phenotype [11]. Rituximab is an established option in refractory disease [12,13]."), (" Follow-up continues.", ""), ] for a,b in rep: assert a in s, a[:40] s = s.replace(a,b) # reorder refs: move Greco & Aggarwal (items 12,13) to positions 8,9 i0 = s.index('refs = [') lines = s[i0:].split('\n') start = 1 rl = [l for l in lines[1:] if l.startswith('"')] rest_idx = lines.index(']') r = rl[:13] new = r[:7] + [r[11], r[12]] + [r[7], r[8], r[9], r[10]] s = s[:i0] + 'refs = [\n' + '\n'.join(new) + '\n' + '\n'.join(lines[rest_idx:]) open('make.py','w').write(s) EOF python3 make.py && python3 -c " from docx import Document d=Document('/tmp/workspace/jic2027/JIC2027_Case_Abstract.docx') for p in d.paragraphs: print(p.text[:140]) print(d.sections[0].footer.paragraphs[0].text)"