A case of sarcoidosis developing as sarcoid myopathy concomitant with systemic sclerosis and review of the literature

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. Muscl...

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Bibliographic Details
Published in:Modern rheumatology 2012-02, Vol.22 (1), p.142-146
Main Authors: Ogane, Kunihiro, Kato, Takashi, Mizushima, Ichiro, Kawano, Mitsuhiro, Yamagishi, Masakazu
Format: Article
Language:English
Subjects:
Antibodies
Biopsy
Case Report
Creatinine
Enzymes
Gallium
Giant cells
Granuloma
Immune system
Kidney
Literature reviews
Lysozyme
Magnetic resonance imaging
Medical diagnosis
Medicine
Medicine & Public Health
Muscles
Myopathy
Myositis
Nephritis
Orthopedics
Peptidyl-dipeptidase A
Prednisolone
Rheumatology
Sarcoidosis
Scintigraphy
Scleroderma
Skin
Systemic sclerosis
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Summary: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.
ISSN:1439-7595
1439-7609
DOI:10.1007/s10165-011-0482-z