Affiliations 

  • 1 Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 2 Department of Radiology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • 3 Department of Pathology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
Acta Med Iran, 2017 Dec;55(12):800-806.
PMID: 29373888

Abstract

A 59-year-old man presented with proximal myopathy, myalgia, and weight loss, with the initial markedly elevated serum creatine kinase at 11,000 U/L. Due to his refusal for muscle biopsy, he was initially treated as inflammatory myositis and responded well with the corticosteroids. However, he subsequently had a relapse of the symptoms with more extensive systemic involvement, i.e., hypercalcemia, lymphadenopathy and subcutaneous nodules. Finally, a biopsy of the thigh and subcutaneous nodule revealed non-caseating granulomatous inflammation, consistent with sarcoidosis. He responded well to the corticosteroids, and finally, azathioprine was added as a steroid-sparing agent. Including our series, there are 103 cases of symptomatic muscle involvement in sarcoidosis patients published in the English literature to date. Further pool analysis of the cases will be reported in this review.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.