Sporadic inclusion body myositis misdiagnosed as idiopathic granulomatous myositis.
We present a case of a 65-year-old woman who was previously diagnosed with idiopathic granulomatous myositis and treated with immunosuppressive therapy for the next 10 years before a clinical diagnosis of inclusion body myositis was made. A review of the previously performed muscle biopsy showed most of the cardinal myopathologic features of sporadic inclusion body myositis, in addition to the granuloma. Her clinical course was strongly suggestive of inclusion body myositis with selective asymmetric weakness of forearm flexor muscles and quadriceps. This report highlights the importance of correlating clinical picture with muscle pathology changes along with judicious use of magnetic resonance imaging and serological studies to establish a definite diagnosis.
Department of Neurology, University of California, Irvine, Irvine, CA, United States.
Monica
M
Lavian
Department of Neurology, University of California, Irvine, Irvine, CA, United States.
Namita
N
Goyal
Department of Neurology, University of California, Irvine, Irvine, CA, United States; Department of Orthopaedic Surgery, University of California, Irvine, Irvine, CA, United States. Electronic address: mozaffar@uci.edu.
Tahseen
T
Mozaffar
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D018450:Disease Progression; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D018979:Myositis, Inclusion Body / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology
D015415:Biomarkers; D007166:Immunosuppressive Agents; D008727:Methotrexate
Granulomatous myositis; Inclusion body myositis; NT5C1A antibody; Sarcoidosis