Work

A 73‐Year‐Old Man With Several Years of Difficulty Climbing Stairs and Frequent Tripping

Year: 2026

Type: article

Abstract: A 73-year-old man presented with progressive weakness and atrophy predominantly affecting the distal finger flexors and quadriceps muscles. Electrophysiological studies demonstrated mixed myogenic and neurogenic features. Muscle MRI showed inflammatory changes, and muscle biopsy revealed granulomatous myositis with histologic features characteristic of inclusion body myositis (IBM), including rimmed vacuoles, TDP-43 mislocalization, and autophagy activation. Additional extensive laboratory and imaging workup ruled out systemic etiologies. An empiric trial of high-dose corticosteroids yielded no clinical improvement. The diagnostic challenge stemmed from the broad differential diagnosis of granulomatous myositis and the possibility that non-IBM etiologies might be responsive to immunosuppressive treatment. This case underscores the importance of integrating clinical, electrophysiologic, radiologic, and histopathologic findings to accurately diagnose and manage granulomatous myositis.

Source: Annals of Clinical and Translational Neurology

DOI: 10.1002/acn3.70322

Authors: Mehmet Can Sari, Arens Taga, Sonya Ulrike Steele, Ahmet Hoke

Institution: Johns Hopkins University

Language: English

Topic: Inflammatory Myopathies and Dermatomyositis

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,100