PT  - JOURNAL ARTICLE
AU  - Dieudonné, Yannick
AU  - Allenbach, Yves
AU  - Benveniste, Olivier
AU  - Leonard-Louis, Sarah
AU  - Hervier, Baptiste
AU  - Mariampillai, Kuberaka
AU  - Nespola, Benoit
AU  - Lannes, Béatrice
AU  - Echaniz-Laguna, Andoni
AU  - Wendling, Daniel
AU  - Von Frenckell, Christian
AU  - Poursac, Nicolas
AU  - Mortier, Emmanuel
AU  - Lavigne, Christian
AU  - Hinschberger, Olivier
AU  - Magnant, Julie
AU  - Gottenberg, Jacques-Eric
AU  - Geny, Bernard
AU  - Sibilia, Jean
AU  - Meyer, Alain
TI  - Granulomatosis-associated myositis
AID  - 10.1212/WNL.0000000000008863
DP  - 2020 Mar 03
TA  - Neurology
PG  - e910--e920
VI  - 94
IP  - 9
4099  - http://n.neurology.org/content/94/9/e910.short
4100  - http://n.neurology.org/content/94/9/e910.full
SO  - Neurology2020 Mar 03; 94
AB  - 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.CK=creatine kinase; DM=dermatomyositis; ENMC=European Neuromuscular Centre; EULAR/ACR=European League Against Rheumatism/American College of Rheumatology; NAM=necrotizing autoimmune myopathy; OM=overlap myositis; PM=polymyositis; sIBM=sporadic inclusion body myositis