A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report

Finangnon Armand Wanvoegbe; Alin Turcu; Herve Devilliers; Romain Bouvet; Suzanne Mouries-Martin; Geraldine Muller; Marion Laboz; Kouessi Anthelme Agbodande; Angele Azon-Kouanou; Philip Bielefeld; Jean-François Besancenot

doi:doi:10.11648/j.ajim.20231101.12

Research Article |

A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report

Finangnon Armand Wanvoegbe^*, Alin Turcu, Herve Devilliers, Romain Bouvet, Suzanne Mouries-Martin, Geraldine Muller, Marion Laboz, Kouessi Anthelme Agbodande, Angele Azon-Kouanou, Philip Bielefeld, Jean-François Besancenot

Published in American Journal of Internal Medicine (Volume 11, Issue 1)

Received: 20 December 2022 Accepted: 11 January 2023 Published: 31 January 2023

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Abstract

Background: Sarcoidosis can affect virtually any organ of the body, primarily the lungs, lymphatic system, skin or eyes, or a combination of these sites and it is characterized by the formation of non-caseating granulomas. Muscular involvement in sarcoidosis is usually asymptomatic or pauci-symptomatic, and its nodular form is exceptional. Observation: In this study, we report the case of a 36-year-old man who had been presenting with nodules in both calves for about two years which onset was progressive. These nodules were painless and deeply embedded in the gastrocnemius muscles. There were no functional complaints, and the general condition was preserved. The physical examination, especially at skin level was free of other clinical signs except the nodules. The PET-scan (positron emission tomography) revealed a few discretely hypermetabolic cervico-axillary lymph nodes and multiple bilateral mediastino-hilar adenopathies involving all lymph nodes, as well as multiple bilateral hypermetabolic pulmonary foci. Biopsy of accessory salivary glands (BASG) exhibited an epithelioid and gigantocellular granuloma without necrosis that confirm the diagnosis of systemic sarcoidosis. The search for another location, notably cardiac, ophthalmological, neurological, or renal, was negative. The respiratory function tests did not show any restrictive syndrome or abnormalities in the DLCO/VA ratio. It was therefore a systemic sarcoidosis with mediastino-pulmonary stage II, diffuse lymph node, splenic, and muscle involvement. Conclusion: This case shows the importance of BASG in the diagnosis of muscular sarcoidosis, in case of impossibility of performing a muscle biopsy.

Published in	American Journal of Internal Medicine (Volume 11, Issue 1)
DOI	10.11648/j.ajim.20231101.12
Page(s)	5-7
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Muscular Nodules, PET Scan, Sarcoidosis, Dijon

References

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[3]	Balageas A, Sanguinet F, Lequen L, Delbrel X. Sarcoïdose musculaire: à propos d’un cas avec atteinte des muscles et des fascias et revue de la littérature. Rev Med Interne 2013; 34: 706-712.
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[6]	Cohen Aubart F, Abbara S, Maisonobe T, Cottin V, Papo T, Haroche J et al. Symptomatic muscular sarcoidosis. Lessons from a nationwide multicenter study. Neurol Neuroimmunol Neuroinflamm 2018; 5: e452. doi: 10.1212/NXI.0000000000000452.
[7]	Sève P, Zénone T, Durieu I, Pillon D, Durand DV. La sarcoïdose musculaire: à propos d’un cas. Rev Med Interne 1997; 18: 984–988.
[8]	Wolfe SM, Pinals RS, Aelion JA, Goodman RE. Myopathy in sarcoïdosis: clinical and pathologic study of four cases and review of the literature. Semin Arthritis Rheum 1987; 16: 300–306.
[9]	Valeyre D, Sarcoidosis. Support is improving. Rev Prat 2008; 10: 1061–1062.
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[11]	Michon-Pasturel U, Hachulla E, Bloget F, Labalette P, Hatron PY, Devulder B et al. Place de la biopsie de glandes salivaires accessoires dans le syndrome de Löfgren et les autres formes de sarcoïdose. Rev Med lnterne 1996; 17: 452-455.
[12]	Baeteman C, Guyot L, Bouvenot J, Chossegros C, Cheynet F, Loudot C et al. Faut-il encore effectuer des biopsies des glandes salivaires accessoires ? Rev Stomatol Chir Maxillofac 2008; 109: 143-147.
[13]	Lopes AI, Machado-Neves R, Honavar M, Pereira PR. The role of minor salivary glands’ biopsy in the diagnosis of Sjögren’s syndrome and other systemic diseases. European Journal of Internal Medicine 2021; 94: 69-72. https://doi.org/10.1016/j.ejim.2021.07.012.
[14]	Baudin B. L’enzyme de conversion de l’angiotensine I (ECA) dans le diagnostic de la sarcoïdose. Pathol Biol 2005; 53: 183–188.
[15]	Londner C, Zendah I, Freynet O, Carton Z, Dion G, Nunes H, et al. Sarcoidosis Treatment. Rev Med Interne 2011; 32: 109–113.

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APA Style

Wanvoegbe, F. A., Turcu, A., Devilliers, H., Bouvet, R., Mouries-Martin, S., et al. (2023). A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report. American Journal of Internal Medicine, 11(1), 5-7. https://doi.org/10.11648/j.ajim.20231101.12

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ACS Style

Wanvoegbe, F. A.; Turcu, A.; Devilliers, H.; Bouvet, R.; Mouries-Martin, S., et al. A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report. Am. J. Intern. Med. 2023, 11(1), 5-7. doi: 10.11648/j.ajim.20231101.12

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AMA Style

Wanvoegbe FA, Turcu A, Devilliers H, Bouvet R, Mouries-Martin S, et al. A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report. Am J Intern Med. 2023;11(1):5-7. doi: 10.11648/j.ajim.20231101.12

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@article{10.11648/j.ajim.20231101.12,
  author = {Finangnon Armand Wanvoegbe and Alin Turcu and Herve Devilliers and Romain Bouvet and Suzanne Mouries-Martin and Geraldine Muller and Marion Laboz and Kouessi Anthelme Agbodande and Angele Azon-Kouanou and Philip Bielefeld and Jean-François Besancenot},
  title = {A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report},
  journal = {American Journal of Internal Medicine},
  volume = {11},
  number = {1},
  pages = {5-7},
  doi = {10.11648/j.ajim.20231101.12},
  url = {https://doi.org/10.11648/j.ajim.20231101.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20231101.12},
  abstract = {Background: Sarcoidosis can affect virtually any organ of the body, primarily the lungs, lymphatic system, skin or eyes, or a combination of these sites and it is characterized by the formation of non-caseating granulomas. Muscular involvement in sarcoidosis is usually asymptomatic or pauci-symptomatic, and its nodular form is exceptional. Observation: In this study, we report the case of a 36-year-old man who had been presenting with nodules in both calves for about two years which onset was progressive. These nodules were painless and deeply embedded in the gastrocnemius muscles. There were no functional complaints, and the general condition was preserved. The physical examination, especially at skin level was free of other clinical signs except the nodules. The PET-scan (positron emission tomography) revealed a few discretely hypermetabolic cervico-axillary lymph nodes and multiple bilateral mediastino-hilar adenopathies involving all lymph nodes, as well as multiple bilateral hypermetabolic pulmonary foci. Biopsy of accessory salivary glands (BASG) exhibited an epithelioid and gigantocellular granuloma without necrosis that confirm the diagnosis of systemic sarcoidosis. The search for another location, notably cardiac, ophthalmological, neurological, or renal, was negative. The respiratory function tests did not show any restrictive syndrome or abnormalities in the DLCO/VA ratio. It was therefore a systemic sarcoidosis with mediastino-pulmonary stage II, diffuse lymph node, splenic, and muscle involvement. Conclusion: This case shows the importance of BASG in the diagnosis of muscular sarcoidosis, in case of impossibility of performing a muscle biopsy.},
 year = {2023}
}

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TY  - JOUR
T1  - A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report
AU  - Finangnon Armand Wanvoegbe
AU  - Alin Turcu
AU  - Herve Devilliers
AU  - Romain Bouvet
AU  - Suzanne Mouries-Martin
AU  - Geraldine Muller
AU  - Marion Laboz
AU  - Kouessi Anthelme Agbodande
AU  - Angele Azon-Kouanou
AU  - Philip Bielefeld
AU  - Jean-François Besancenot
Y1  - 2023/01/31
PY  - 2023
N1  - https://doi.org/10.11648/j.ajim.20231101.12
DO  - 10.11648/j.ajim.20231101.12
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 5
EP  - 7
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20231101.12
AB  - Background: Sarcoidosis can affect virtually any organ of the body, primarily the lungs, lymphatic system, skin or eyes, or a combination of these sites and it is characterized by the formation of non-caseating granulomas. Muscular involvement in sarcoidosis is usually asymptomatic or pauci-symptomatic, and its nodular form is exceptional. Observation: In this study, we report the case of a 36-year-old man who had been presenting with nodules in both calves for about two years which onset was progressive. These nodules were painless and deeply embedded in the gastrocnemius muscles. There were no functional complaints, and the general condition was preserved. The physical examination, especially at skin level was free of other clinical signs except the nodules. The PET-scan (positron emission tomography) revealed a few discretely hypermetabolic cervico-axillary lymph nodes and multiple bilateral mediastino-hilar adenopathies involving all lymph nodes, as well as multiple bilateral hypermetabolic pulmonary foci. Biopsy of accessory salivary glands (BASG) exhibited an epithelioid and gigantocellular granuloma without necrosis that confirm the diagnosis of systemic sarcoidosis. The search for another location, notably cardiac, ophthalmological, neurological, or renal, was negative. The respiratory function tests did not show any restrictive syndrome or abnormalities in the DLCO/VA ratio. It was therefore a systemic sarcoidosis with mediastino-pulmonary stage II, diffuse lymph node, splenic, and muscle involvement. Conclusion: This case shows the importance of BASG in the diagnosis of muscular sarcoidosis, in case of impossibility of performing a muscle biopsy.
VL  - 11
IS  - 1
ER  -

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Author Information

Finangnon Armand Wanvoegbe

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France; Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin

Contact Email
Alin Turcu

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France
Herve Devilliers

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France
Romain Bouvet

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France
Suzanne Mouries-Martin

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France
Geraldine Muller

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France
Marion Laboz

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France
Kouessi Anthelme Agbodande

Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Angele Azon-Kouanou

Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
Philip Bielefeld

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France
Jean-François Besancenot

Internal Medicine and Systemic Diseases, University Hospital of Dijon Bourgogne, Dijon, France

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Plain Text BibTeX RIS

APA Style

Wanvoegbe, F. A., Turcu, A., Devilliers, H., Bouvet, R., Mouries-Martin, S., et al. (2023). A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report. American Journal of Internal Medicine, 11(1), 5-7. https://doi.org/10.11648/j.ajim.20231101.12

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ACS Style

Wanvoegbe, F. A.; Turcu, A.; Devilliers, H.; Bouvet, R.; Mouries-Martin, S., et al. A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report. Am. J. Intern. Med. 2023, 11(1), 5-7. doi: 10.11648/j.ajim.20231101.12

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AMA Style

Wanvoegbe FA, Turcu A, Devilliers H, Bouvet R, Mouries-Martin S, et al. A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report. Am J Intern Med. 2023;11(1):5-7. doi: 10.11648/j.ajim.20231101.12

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@article{10.11648/j.ajim.20231101.12,
  author = {Finangnon Armand Wanvoegbe and Alin Turcu and Herve Devilliers and Romain Bouvet and Suzanne Mouries-Martin and Geraldine Muller and Marion Laboz and Kouessi Anthelme Agbodande and Angele Azon-Kouanou and Philip Bielefeld and Jean-François Besancenot},
  title = {A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report},
  journal = {American Journal of Internal Medicine},
  volume = {11},
  number = {1},
  pages = {5-7},
  doi = {10.11648/j.ajim.20231101.12},
  url = {https://doi.org/10.11648/j.ajim.20231101.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20231101.12},
  abstract = {Background: Sarcoidosis can affect virtually any organ of the body, primarily the lungs, lymphatic system, skin or eyes, or a combination of these sites and it is characterized by the formation of non-caseating granulomas. Muscular involvement in sarcoidosis is usually asymptomatic or pauci-symptomatic, and its nodular form is exceptional. Observation: In this study, we report the case of a 36-year-old man who had been presenting with nodules in both calves for about two years which onset was progressive. These nodules were painless and deeply embedded in the gastrocnemius muscles. There were no functional complaints, and the general condition was preserved. The physical examination, especially at skin level was free of other clinical signs except the nodules. The PET-scan (positron emission tomography) revealed a few discretely hypermetabolic cervico-axillary lymph nodes and multiple bilateral mediastino-hilar adenopathies involving all lymph nodes, as well as multiple bilateral hypermetabolic pulmonary foci. Biopsy of accessory salivary glands (BASG) exhibited an epithelioid and gigantocellular granuloma without necrosis that confirm the diagnosis of systemic sarcoidosis. The search for another location, notably cardiac, ophthalmological, neurological, or renal, was negative. The respiratory function tests did not show any restrictive syndrome or abnormalities in the DLCO/VA ratio. It was therefore a systemic sarcoidosis with mediastino-pulmonary stage II, diffuse lymph node, splenic, and muscle involvement. Conclusion: This case shows the importance of BASG in the diagnosis of muscular sarcoidosis, in case of impossibility of performing a muscle biopsy.},
 year = {2023}
}

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TY  - JOUR
T1  - A Rare Presentation of Muscle Involvement in Sarcoidosis: A Case Report
AU  - Finangnon Armand Wanvoegbe
AU  - Alin Turcu
AU  - Herve Devilliers
AU  - Romain Bouvet
AU  - Suzanne Mouries-Martin
AU  - Geraldine Muller
AU  - Marion Laboz
AU  - Kouessi Anthelme Agbodande
AU  - Angele Azon-Kouanou
AU  - Philip Bielefeld
AU  - Jean-François Besancenot
Y1  - 2023/01/31
PY  - 2023
N1  - https://doi.org/10.11648/j.ajim.20231101.12
DO  - 10.11648/j.ajim.20231101.12
T2  - American Journal of Internal Medicine
JF  - American Journal of Internal Medicine
JO  - American Journal of Internal Medicine
SP  - 5
EP  - 7
PB  - Science Publishing Group
SN  - 2330-4324
UR  - https://doi.org/10.11648/j.ajim.20231101.12
AB  - Background: Sarcoidosis can affect virtually any organ of the body, primarily the lungs, lymphatic system, skin or eyes, or a combination of these sites and it is characterized by the formation of non-caseating granulomas. Muscular involvement in sarcoidosis is usually asymptomatic or pauci-symptomatic, and its nodular form is exceptional. Observation: In this study, we report the case of a 36-year-old man who had been presenting with nodules in both calves for about two years which onset was progressive. These nodules were painless and deeply embedded in the gastrocnemius muscles. There were no functional complaints, and the general condition was preserved. The physical examination, especially at skin level was free of other clinical signs except the nodules. The PET-scan (positron emission tomography) revealed a few discretely hypermetabolic cervico-axillary lymph nodes and multiple bilateral mediastino-hilar adenopathies involving all lymph nodes, as well as multiple bilateral hypermetabolic pulmonary foci. Biopsy of accessory salivary glands (BASG) exhibited an epithelioid and gigantocellular granuloma without necrosis that confirm the diagnosis of systemic sarcoidosis. The search for another location, notably cardiac, ophthalmological, neurological, or renal, was negative. The respiratory function tests did not show any restrictive syndrome or abnormalities in the DLCO/VA ratio. It was therefore a systemic sarcoidosis with mediastino-pulmonary stage II, diffuse lymph node, splenic, and muscle involvement. Conclusion: This case shows the importance of BASG in the diagnosis of muscular sarcoidosis, in case of impossibility of performing a muscle biopsy.
VL  - 11
IS  - 1
ER  -

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