title: A case of sarcoidosis developing as sarcoid myopathy concomitant with systemic sclerosis and review of the literature.
abstract: A 65-year-old man was diagnosed with systemic sclerosis on the basis of skin thickening and positivity of anti-Scl-70 antibodies. Because myogenic enzymes, such as creatinine phosphokinase and aldorase, were also elevated, myopathy or myositis associated with systemic sclerosis was considered. Muscle magnetic resonance imaging and gallium scintigraphy did not show abnormalities. Findings of muscle biopsy demonstrated presence of noncaseating granulomas with multinucleated giant cells. In addition, serum angiotensin-converting enzyme and lysozyme were elevated, and therefore a diagnosis of sarcoid myopathy was made. Further, renal sarcoidosis was revealed with renal biopsy. Prednisolone (40 mg/day) improved both the myopathy and nephritis. Sarcoid myopathy is a rare condition, but it should be considered when myogenic enzymes are elevated in the patient with systemic sclerosis. Further, muscle biopsy may be essential to make an accurate diagnosis in such condition.
authors.affiliation: Division of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, 2-1 Kuratsuki-higashi, Kanazawa 920-8530, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Ogane
authors.forename: Takashi
authors.initials: T
authors.lastname: Kato
authors.forename: Ichiro
authors.initials: I
authors.lastname: Mizushima
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kawano
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D000368:Aged; D001706:Biopsy; D015726:Giant Cells / Q000473:pathology; D006099:Granuloma / Q000473:pathology; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D008297:Male; D009113:Muramidase / Q000097:blood; D018482:Muscle, Skeletal / Q000473:pathology; D009135:Muscular Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D012083:Renin / Q000097:blood; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012595:Scleroderma, Systemic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D011239:Prednisolone; D009113:Muramidase; D012083:Renin