Myopathies Featuring Non-caseating Granulomas: Sarcoidosis, Inclusion body myositis and an unfolding overlap

Granulomatous myopathy is a clinically and etiologically heterogeneous group of uncommon inflammatory myopathies, pathologically characterized by the presence of granulomas in skeletal muscle. Granulomas may contain necrosis as typically seen in infectious disorders (fungal, tuberculosis, or brucellosis) [1-3] or may occur without necrosis, so-called non-necrotizing or non-caseating granulomas. Various disorders were reported in association with non-caseating granulomatous myopathy, including sarcoidosis and less commonly other autoimmune diseases (Crohn’s disease, anti-mitochondrial autoimmunity with or without primary biliary cirrhosis, myasthenia gravis, and programmed cell death-1 inhibitor-associated myopathy) or neoplastic conditions (thymoma and lymphoma) [4-10].

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