title: Granulomatous myositis: a clinical study of thirteen cases.
abstract: Granulomatous myositis (GM) is a rare condition that has generally been described in association with sarcoidosis. In the absence of sarcoidosis or other underlying disease, a diagnosis of isolated GM is considered. Only one study has focused on the clinical difference between isolated GM and sarcoid myopathy (SM). We report 13 cases of symptomatic GM; 8 had sarcoidosis. All patients with sarcoidosis had predominantly proximal, symmetrical lower-limb weakness, and 3 subsequently developed upper-limb or distal involvement. Three of the five patients with isolated GM had predominantly distal muscle involvement, and two had dysphagia. Corticosteroid treatment was followed by prolonged improvement in only one patient with sarcoidosis. One patient had acute sarcoid myositis and benefited from methotrexate; other immunosuppressants and etanercept proved ineffective in chronic sarcoid myopathy. Three of the five patients with isolated GM responded to corticosteroid treatment. When last examined, three patients with sarcoidosis had severe disability, whereas patients with isolated GM showed milder weakness. Thus, SM was frequently associated with severe disability and rarely improved after corticosteroid treatment, whereas most patients with isolated GM improved.
authors.affiliation: Hospices Civils de Lyon, Université Claude Bernard Lyon I, Lyon, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Le Roux
authors.forename: Nathalie
authors.initials: N
authors.lastname: Streichenberger
authors.forename: Christophe
authors.initials: C
authors.lastname: Vial
authors.forename: Philippe
authors.initials: P
authors.lastname: Petiot
authors.forename: Leonard
authors.initials: L
authors.lastname: Feasson
authors.forename: Françoise
authors.initials: F
authors.lastname: Bouhour
authors.forename: Jacques
authors.initials: J
authors.lastname: Ninet
authors.forename: Florence
authors.initials: F
authors.lastname: Lachenal
authors.forename: Christiane
authors.initials: C
authors.lastname: Broussolle
authors.forename: Pascal
authors.initials: P
authors.lastname: Sève
mesh_terms: D000368:Aged; D005260:Female; D006099:Granuloma / Q000150:complications / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000209:etiology / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000473:pathology