[Clinical analysis of 10 patients with muscular sarcoidosis presenting muscle mass as initial symptom]

To investigate clinical characteristics of muscular sarcoidosis presenting muscle mass as initial symptom. The clinical data of 10 patients diagnosed with muscular sarcoidosis and admitted in the Second Affiliated Hospital of Zhejiang University School of Medicine from May 2014 to October 2020 were collected and retrospectively analyzed. All patients were female, including 2 patients with unilateral involvement of lower extremities, 7 patients with bilateral involvement of lower extremities, and 1 patient with bilateral involvement of upper and lower extremities. Lung lesions were presented in all patients, and 9 cases had mediastinal lymphadenopathy. Serum angiotensin-converting enzyme (sACE) was 57-118 IU/ml. No specific characteristics were found by ultrasound. Typical "dark-star" sign and "three-stripe" sign were shown in the magnetic resonance imaging (MRI). The pathology of striated muscle was non-necrotizing granulomatous inflammation. Three patients were not treated. In 7 patients treated with prednisone 0.5-1 mg ·kg^-¹·d^-¹, immunosuppressants were combined in 3 patients at initial and the other 4 patients later on. During the follow-up of 7-62 months, 1 patient was stable, 6 improved and 3 relapsed. Till now, 5 patients are still on the treatment of glucocorticoid and immunosuppressant.