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

Mod Rheumatol. 2012 Feb;22(1):142-6. doi: 10.1007/s10165-011-0482-z. Epub 2011 Jun 16.


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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Biopsy
  • Giant Cells / pathology
  • Granuloma / pathology
  • Humans
  • Kidney Diseases / drug therapy
  • Kidney Diseases / etiology
  • Kidney Diseases / pathology
  • Male
  • Muramidase / blood
  • Muscle, Skeletal / pathology
  • Muscular Diseases / complications*
  • Muscular Diseases / diagnosis
  • Muscular Diseases / drug therapy
  • Prednisolone / therapeutic use
  • Renin / blood
  • Sarcoidosis / complications*
  • Sarcoidosis / diagnosis
  • Sarcoidosis / drug therapy
  • Scleroderma, Systemic / complications*
  • Scleroderma, Systemic / diagnosis
  • Scleroderma, Systemic / drug therapy
  • Treatment Outcome


  • Prednisolone
  • Muramidase
  • Renin