Isolated sarcoid myopathy: an unusual presentation

Sarcoidosis is a systemic disease with protean clinical manifestations, pathologically characterized by the development of a non-caseating granuloma. Any organ system may be involved during the course of the disease with lung, liver, skin and eyes being commonly involved. Muscular sarcoidosis is a rare entity, seen in approximately 6% of patients with sarcoidosis. Symptomatic muscle involvement is even rarer, noted in less than 0.5% of patients. We report the case of a young male patient (14 years old), who presented to our hospital with unilateral hypertrophy of shoulder and calf muscles. After excluding all the possible causes, it was surprisingly diagnosed to be a case of muscle involvement with sarcoidosis. Patient also improved significantly with oral corticosteroid therapy. This report therefore highlights the importance of keeping this rare cause in mind when the common etiologies are excluded in a patient with hypertrophy of muscle. It may be rewarding if diagnosis is established early.