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A 46-year-old man with Raynaud's disease who emigrated from Cambodia 30 years ago presented with a 2-month history of myalgias, exertional dyspnea, and an elevated level of creatine kinase. An extensive evaluation was notable for the ground-glass infiltrates detected in the lower lobes on a computed tomographic scan of the thorax. Serologic tests and bronchoalveolar lavage were unrevealing. A specimen from a muscle biopsy showed necrotizing myopathy. Empirical therapy with oral corticosteroids was begun for treatment of an inflammatory condition that was presumed to be noninfectious. Four weeks after therapy was initiated, the muscle weakness and dyspnea were worse and . . . [Full Text of this Article] |
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