Sarcoid Myopathy Mimicking Polymyositis: A Case Report and Pool Analysis of the Literature Reviews
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Syahrul Sazliyana Shaharir
,
Adawiyah Jamil
,
Sumitro Kosasih
,
Low Soo Fin
,
Radhika Sridharan
,
Suria Hayati Md Pauzi
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.
Costabel U. Skeletal muscle weakness, fatigue and sarcoidosis. Thorax 2005;60:1-2.
Asano M, Minagawa T, Ohmichi M, Hiraga Y. Detection of endogenous cytokines in sera or in lymph nodes obtained from patients with sarcoidosis. Clin Exp Immunol 1991;84:92-6.
Shijubo N, Imai K, Shigehara K, Honda Y, Koba H, Tsujisaki M, et al. Soluble intercellular adhesion molecule-1 (ICAM-1) in sera and bronchoalveolar lavage fluid of patients with idiopathic pulmonary fibrosis and pulmonary sarcoidosis. Clin Exp Immunol 1994;95:156-61.
Muller-Quernheim J. The cytokine network in sarcoidosis. Eur Cytokine Netw 1996;7:13-26.
Silverstein A, Siltzbach LE. Muscle involvement in sarcoidosis. Asymptomatic, myositis, and myopathy. Arch Neurol 1969;21:235-41.
Otake S, Ishigaki T. Muscular sarcoidosis. Semin Musculoskelet Radiol 2001;5:167-70.
Fayad F, Liote F, Berenbaum F, Orcel P, Bardin T. Muscle involvement in sarcoidosis: a retrospective and followup studies. J Rheumatol 2006;33:98-103.
Anakwenze OA, Kancherla V, Hatch M, Brooks JS, Ogilvie CM. Primary musculoskeletal sarcoidosis. Orthopedics 2010;33.
Pringle CE, Dewar CL. Respiratory muscle involvement in severe sarcoid myositis. Muscle Nerve 1997;20:379-81.
Ost D, Yeldandi A, Cugell D. Acute sarcoid myositis with respiratory muscle involvement. Case report and review of the literature. Chest 1995;107:879-82.
Levine CD, Miller JJ, Stanislaus G, Wachsberg RH, Simmons M. Sarcoid myopathy: Imaging findings. J Clin Ultrasound 1997;25:515-7.
Y. Ahmedani FQ GK. Sarcoidosis presenting as Proximal Myopathy. J Pak Med Assoc 2003;53.
Sepulveda-Sanchez JM, Villarejo-Galende A, Cabello A, Alonso-Ortiz A, Ibero-Esparza C, Porta-Etessam J. [Sarcoid myopathy. Report of two cases and review of the bibliography]. Rev Neurol 2005;41:159-62.
Scola RH, Werneck LC, Prevedello DMS, Greboge P, Iwamoto FM. Symptomatic muscle involvement inneurosarcoidosis: a clinicopathological study of 5 cases. Arq Neuropsiquiatr 2001;59:347-52.
Berger C, Sommer C, Meinck HM. Isolated sarcoid myopathy. Muscle Nerve 2002;26:553-6.
Kobak S, Yalcin M, Sever F, Oncel G. Sarcoidosis Presenting as Lofgren's Syndrome with Myopathy. Case Rep Rheumatol 2013;2013:125251.
Fujita H, Ishimatsu Y, Motomura M, Kakugawa T, Sakamoto N, Hayashi T, et al. A case of acute sarcoid myositis treated with weekly low-dose methotrexate. Muscle Nerve 2011;44:994-9.
Guo M, Lemos L, Baliga M. Nodular Sarcoid Myositis of Skeletal Muscle Diagnosed by Fine Needle Aspiration Biopsy. Acta Cytologica 1999;43:1171-6.
Dewberry RG, Schneider BF, Cale WF, Phillips LH, 2nd. Sarcoid myopathy presenting with diaphragm weakness. Muscle Nerve 1993;16:832-5.
Schydlowsky P, Remvig L. [Sarcoidosis presenting as symptomatic myopathy]. Ugeskr Laeger 1993;155:807-8.
Sugo A, Seyama K, Yaguchi T, Noto K, Kira S, Yamaguchi H. [Cardiac sarcoidosis with myopathy and advanced A-V nodal block in a woman with a previous diagnosis of sarcoidosis]. Nihon Kyobu Shikkan Gakkai Zasshi 1995;33:1111-8.
A L. Moskauer venerologische und dermatotogische Gesellschaft. Dermat Zentralb 1908;11:253-4.
Zur frage des Boeckschen lupoids. Arch Derm Syph 1914;119:133-5.
Mucha V. Orzechowski K. Ein Fall von Tuberkuloser Dermatomyositis. Wien Klin Wschr 1919;32:25.
Sundelin F. Tumeurs multiples disseminees dan les muscles des extremites et rappelant la tuberculose par leur structure histologique. Acta Med Scand 1925;62:442-60.
Bergel A. Scharff O. Zur internen Klinik des Boeckschen Miliarlupoids. Wien Klin Wschr 1933;46:1224-127.
Longcope WT, Pierson JW. Boeck's sarcoid (sarcoidosis). Bull Johns Hopkins Hosp 1937;60:223-96.
Harrell GT. Generalized sarcoidosis of Boeck. Arch intern Med 1940;65:1003-4.
Snorrason E. Myositis fibrosa progressiva-Lymphogranulomatosis benigna Boeck. Nord Med 1947;36:2424-5.
Bates GS, Walsh JM. Boeck's sarcoid; observations on seven patients, one autopsy. Ann Intern Med 1948;29:306-17.
Krabbe KH. Muscular localization of benign lymphogranulomatosis. Acta Med Scand 1949;136:193-8.
Vismans JBM. Besnier-Boeck's disease with localization in certain muscles. Ned Tijdschr Geneeskd 1951;95:3870-3.
Powell LW, Jr. Sarcoidosis of skeletal muscle; report of 6 cases and review of the literature. Am J Clin Pathol 1953;23:881-9.
Klotz HP, Rubens-Duval A, Desse G, Chimenes. The muscular form of Besnier-Boeck-Schaumann disease. Rev Prat 1955;5:132-7.
Lafon R, Pages P, Passouant P, Labauge R, Minvielle J, Pages A. Muscular localizations of Besnier-Boeck-Schaumann disease; report of three cases. Rev Neurol (Paris) 1955;92:557-63.
Goodson WH, Jr. Neurologic manifestations of sarcoidosis. South Med J 1960;53:1111-6.
Ozer FL, Johnson WA, Waggener JD. Muscular sarcoidosis; a case with "tumour" formation. Lancet 1961;1:22-4.
Eguro H, Yabuki M. Sarcoidosis of the skeletal muscle with tumor formation. A case report and review of the literature. Yokohama Med Bull 1966;17:75-90.
Larcan A, Guerci O, Floquet J, Bey P. Isolation muscular sarcoidosis of tumoral form. Ann Med Interne (Paris) 1971;122:119-20.
Turiaf J, Battesti JP, Basset F. Hypertrophic nodular muscular sarcoidosis. Ann Med Interne (Paris) 1975;126:503-8.
Bucholz R. Sarcoid tumor in skeletal muscle. A case report. Clin Orthop Relat Res 1978;131:224-6.
Vital C, Vallat JM, Gruyer G, Coquet M, Rivel J. Etude anatomo-clinique de vingt-cinq cas de sarcoidose musculaire. Anat Cytol Pathol 1980:214-21.
Caroit M. BE. Un case de sarcoidose musculaire a la forme nodulaire. Rev Rhum 1980;47:379-80.
Cameron HU. Symmetrical muscle contractures in tumorous sarcoidosis: report of a case. Clin Orthop Relat Res 1981;155:108-10.
Montejo Baranda M, Martinez Gutierrez E, Arrinda Yeregui JM, Aguirre Errasti C. Nodular myositis as the initial manifestation of sarcoidosis. Med Clin (Barc) 1983;81:739-40.
Otake S. Sarcoidosis involving skeletal muscle: imaging findings and relative value of imaging procedures. AJR Am J Roentgenol 1994;162:369-75.
Kurashima K, Shimizu H, Ogawa H, Ohka T, Nobata K, Ueno K, et al. MR and CT in the evaluation of sarcoid myopathy. J Comput Assist Tomogr 1991;15:1004-7.
Janssen M, Dijkmans BA, Eulderink F. Muscle cramps in the calf as presenting symptom of sarcoidosis. Ann Rheum Dis 1991;50:51-2.
Kobayashi H, Kotoura Y, Sakahara H, Yamamuro T, Endo K, Konishi J. Solitary muscular sarcoidosis: CT, MRI, and scintigraphic characteristics. Skeletal Radiol 1994;23:293-5.
Hermosilla E, Lagueny A, Kien P, Coquet M, Puymirat E.Localized muscular hypertrophy in a familial form of sarcoidosis. Rev Med Interne 1995;16:843-6.
Edan G, Bourguet P, Delaval P, Herry JY. Gallium-67 Imaging in Muscular Sarcoidosis. J Nuc à Med 1984;25:776-8.
Ahmad Z, Skinner J, Field R. Sarcoid myositis: a rare presentation. BMJ Case Reports 2010;2010.
Yamamoto T, Nagira K, Akisue T, Marui T, Hitora T, Nakatani T, et al. Aspiration biopsy of nodular sarcoidosis of the muscle. Diagn Cytopathol 2002;26:109-12.
Marie I, Levesque H, Manrique A, Vera P, Mehdaoui A. Positron emission tomography in the diagnosis of muscular sarcoidosis. Am J Med 2007;120:e1-2.
Marie I, Lahaxe L, Vera P, Edet-Samson A. Follow-up of muscular sarcoidosis using fluorodeoxyglucose positron emission tomography. QJM 2010;103:1000-2.
Saharan S, Majithia V. Isolated muscle mass as an initial presentation of sarcoidosis: a case report and discussion. J Miss State Med Assoc 2008;49:107-9.
Takuma H, Murayama S, Watanabe M, Saito Y, Ugawa Y, Kanazawa I. A severe case of subacute sarcoid myositis. J Neurol Sci 2000;175:140-4.
Yamada H, Ishii W, Ito S, Iwanami K, Ogishima H, Suzuki T, et al. Sarcoid myositis with muscle weakness as a presenting symptom. Mod Rheumatol 007;17:243-6.
Karadeli E, Ulu EM. Acute sarcoid myositis with unusual radiologic findings. Diagn Interv Imaging 2010;16:232-5.
Bell JR, Withrington RH, Entwisle KG. Case of the month. TB or not TB? Br J Radiol 2000;73:1127-8.
Warburg M. A case of symmetrical muscular contractures due to sarcoidosis. J Neuropathol Exp Neurol 1955;14:313-5.
Zisman DA, Biermann JS, Martinez FJ, Devaney KO, Lynch JP, 3rd. Sarcoidosis presenting as a tumorlike muscular lesion. Case report and review of the literature. Medicine (Baltimore) 1999;78:112-22.
Licharew W. Moskauer venerologische und dermatologische Gesellschaft. Dermatol Zentralbl 1908;11:235.
Stjernberg N, Cajander S, Truedsson H, Uddenfeldt P. Muscle involvement in sarcoidosis. Acta Med Scand 1981;209:213-6.
Kidd D, Beynon HL. The neurological complications of systemic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2003;20:85-94.
Teirstein A. Neuromuscular sarcoidosis. Semin Respir Crit Care Med 2002;23:505-12.
Berger C SC, Memik HM. Isolated sarcoidosis myopathy. Muscle Nerve 2002;26:553-6.
Ahmedani Y, Qadir F, Khalid G. Sarcoidosis presenting as Proximal Myopathy. JPMA 2003;53:1.
Judson MA BR, Thompson BW, Teirstein AS, Terrin ML, Rossman MD, et al. Two year prognosis of sarcoidosis: the ACCESS experience. Sarcoidosis Vasc Diffuse Lung Dis 2003;20:204-11.
Suehiro S, Shiokawa S, Taniguchi S, Sakai Y, Goda H, Shiratsuchi M, et al. Gallium-67 scintigraphy in the diagnosis and management of chronic sarcoid myopathy. Clin Rheumatol 2003;22:146-8.
Sohn HS, Kim EN, Park JM, Chung YA. Muscular sarcoidosis: Ga-67 scintigraphy and magnetic resonance imaging. Clin Nucl Med 2001;26:29-32.
Gottlieb JE, Israel HL, Steiner RM, Triolo J, Patrick H. Outcome in sarcoidosis : The relationship of relapse to corticosteroid therapy. Chest J 1997;111:623-31.
Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999;160:736-55.
Saleh S, Ghodsian S, Yakimova V, Henderson J, Sharma OP. Effectiveness of infliximab in treating selected patients with sarcoidosis.Respir Med 2006;100:2053-9.
| Files | ||
| Issue | Vol 55, No 12 (2017) | |
| Section | Case Report(s) | |
| Keywords | ||
| Granuloma Myopathy Sarcoidosis Subcutaneous nodules | ||
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