title: A case of acute sarcoid myositis treated with weekly low-dose methotrexate.
abstract: A 25-year-old man was referred to our hospital with a 2-month history of progressive proximal extremity weakness. His serum creatine kinase (CK) level was extremely elevated, and chest X-ray revealed bilateral hilar lymphadenopathy and small nodules in bilateral lung fields. Biopsy specimens obtained from muscle and lung revealed non-caseating epithelioid cell granulomas. On the basis of these findings, the patient was diagnosed with sarcoidosis and acute sarcoid myositis. Although steroid pulse therapy was administered repeatedly, the muscle symptoms did not improve, and the serum CK level remained high. We added 7.5 mg oral methotrexate once per week to oral prednisolone, and this improved both the muscle weakness and the CK level. Concurrent administration of methotrexate could be a therapeutic option for cases with acute sarcoid myositis refractory to steroid therapy.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
authors.forename: Hanako
authors.initials: H
authors.lastname: Fujita
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ishimatsu
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Motomura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kakugawa
authors.forename: Noriho
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Tomayoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000328:Adult; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D009220:Myositis / Q000175:diagnosis* / Q000188:drug therapy*; D012507:Sarcoidosis / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D008727:Methotrexate