Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 55 12 2018 01 16 800 806 EN Syahrul Sazliyana Shaharir Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia. Adawiyah Jamil Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia. Sumitro Kosasih Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia. Low Soo Fin Department of Radiology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia. Radhika Sridharan Department of Radiology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia. Suria Hayati Md Pauzi Department of Pathology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia. 2016 02 28 2017 01 02 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. https://acta.tums.ac.ir/index.php/acta/article/view/5472 https://acta.tums.ac.ir/index.php/acta/article/download/5472/5034