Inflammatory Myositis Without Borders, Case Report

Abstract Idiopathic inflammatory myopathies (IIM) are rare chronic inflammatory diseases whose etiologies are not clearly known, which particularly involve muscles, and which can also affect many other organs. There are many subgroups of inflammatory myositis under the roof of IIM, and there are intermediate form cases which do not comply with these. A 85-year-old female patient presented to our clinic with the complaints of prevalent muscle pain that started 15 days ago and increased progressively, weakness in arms and legs, and difficulty to swallow. Muscle biopsy was performed in the patient whose elevated muscle enzymes and electromyography and magnetic resonance imaging (MRI) findings were consistent with inflammatory myositis. Although the histopathological examination of muscle biopsy was consistent with inflammatory myositis, it did not completely comply with any of the known forms. As the patient’s dysphagia increased and aphonia developed in the follow-up, pulse steroid, intravenous immune globulin, and azathioprine treatment in the aftermath was started. In the posttreatment 24th month, the case is being followed up in remission. Differential diagnosis of myopathies includes infection, malignance, drug use, autoimmune diseases, IIM, etc. Although our knowledge of IIM is increasing, a final diagnosis could not be established for some cases with clinical symptoms, laboratory tests, MRI, and even with biopsy. As in our case, there may be cases which do not comply with IIM subgroup boundaries, and new research is needed for the clarification of these boundaries.