Granulomatosis-associated myositis: High prevalence of sporadic inclusion body myositis
- PMID: 31882529
- DOI: 10.1212/WNL.0000000000008863
Granulomatosis-associated myositis: High prevalence of sporadic inclusion body myositis
Abstract
Objective: To refine the predictive significance of muscle granuloma in patients with myositis.
Methods: A group of 23 patients with myositis and granuloma on muscle biopsy (granuloma-myositis) from 8 French and Belgian centers was analyzed and compared with (1) a group of 23 patients with myositis without identified granuloma (control-myositis) randomly sampled in each center and (2) a group of 20 patients with sporadic inclusion body myositis (sIBM) without identified granuloma (control-sIBM).
Results: All but 2 patients with granuloma-myositis had extramuscular involvement, including signs common in sarcoidosis that were systematically absent in the control-myositis and the control-sIBM groups. Almost half of patients with granuloma-myositis matched the diagnostic criteria for sIBM. In these patients, other than the granuloma, the characteristics of the myopathy and its nonresponse to treatment were similar to the control-sIBM patients. Aside from 1 patient with myositis overlapping with systemic sclerosis, the remaining patients with granuloma-myositis did not match the criteria for a well-defined myositis subtype, suggesting pure sarcoidosis. Matching criteria for sIBM was the sole feature independently associated with nonresponse to myopathy treatment in patients with granuloma-myositis.
Conclusion: Patients with granuloma-myositis should be carefully screened for sIBM associated with sarcoidosis in order to best tailor their care.
© 2019 American Academy of Neurology.
Comment in
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Reader response: Granulomatosis-associated myositis: High prevalence of sporadic inclusion body myositis.Neurology. 2020 Dec 1;95(22):1023-1024. doi: 10.1212/WNL.0000000000011068. Neurology. 2020. PMID: 33257514 No abstract available.
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Author response: Granulomatosis-associated myositis: High prevalence of sporadic inclusion body myositis.Neurology. 2020 Dec 1;95(22):1024. doi: 10.1212/WNL.0000000000011067. Neurology. 2020. PMID: 33257515 No abstract available.
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