This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
In the article “Granulomatosis-associated myositis: High prevalence of sporadic inclusion body myositis,” Dr. Dieudonné et al. examined the predictive significance of muscle granulomas in patients with myositis. They examined 23 patients with myositis and granulomas, 23 with myositis without granuloma, and 20 with sporadic inclusion body myositis (sIBM) without granulomas. They found that all but 2 patients with granulomatosis-associated myositis had extramuscular manifestations common in sarcoidosis that were systematically absent in the control groups and that half of these patients also met diagnostic criteria for sIBM with expected poor response to treatment. They concluded that patients with granulomatosis-associated myositis should be carefully screened for associated sIBM. In response, Drs. Liewluck and Alhammad cite similar findings in 2 prior publications. Noting that the majority of their patients with treatment-refractory granulomatous myositis had sarcoplasmic congophilic deposits, they posit that such deposits could indicate treatment refractoriness, regardless of whether the patients meet criteria for sIBM. They enquire whether the authors performed Congo Red staining for their samples, this being more widely available than the TDP43 and p62 immunostains mentioned in the paper. Responding to these comments, the authors note that Congo Red staining was performed in samples from 12 patients (48%), with sarcoplasmic congophilic deposits found in 2 patients who also met sIBM criteria and were treatment refractory, and agree that an epidemiologic study of the incidence of sIBM in sarcoidosis could be valuable. This exchange highlights the remarkable copathologies that are being uncovered in neuromuscular disease.
In the article “Granulomatosis-associated myositis: High prevalence of sporadic inclusion body myositis,” Dr. Dieudonné et al. examined the predictive significance of muscle granulomas in patients with myositis. They examined 23 patients with myositis and granulomas, 23 with myositis without granuloma, and 20 with sporadic inclusion body myositis (sIBM) without granulomas. They found that all but 2 patients with granulomatosis-associated myositis had extramuscular manifestations common in sarcoidosis that were systematically absent in the control groups and that half of these patients also met diagnostic criteria for sIBM with expected poor response to treatment. They concluded that patients with granulomatosis-associated myositis should be carefully screened for associated sIBM. In response, Drs. Liewluck and Alhammad cite similar findings in 2 prior publications. Noting that the majority of their patients with treatment-refractory granulomatous myositis had sarcoplasmic congophilic deposits, they posit that such deposits could indicate treatment refractoriness, regardless of whether the patients meet criteria for sIBM. They enquire whether the authors performed Congo Red staining for their samples, this being more widely available than the TDP43 and p62 immunostains mentioned in the paper. Responding to these comments, the authors note that Congo Red staining was performed in samples from 12 patients (48%), with sarcoplasmic congophilic deposits found in 2 patients who also met sIBM criteria and were treatment refractory, and agree that an epidemiologic study of the incidence of sIBM in sarcoidosis could be valuable. This exchange highlights the remarkable copathologies that are being uncovered in neuromuscular disease.
Footnotes
Author disclosures are available upon request (journal{at}neurology.org).
- © 2020 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.