Two patients with chronic sarcoid myopathy are described. Both were middle-aged females and both showed the features of pseudohypertrophy. In other aspects they contrasted markedly. In one (A.R.) the sheer volume of granuloma and its effect on muscle fibres was sufficient to explain the muscle weakness and electromyography confirmed a pure myopathy. In the other (J.W.) the muscle granuloma was sparsely distributed and an associated neuropathy contributed importantly to the disability. There was no clinical evidence of sarcoidosis of other organs in one (A.R.) but necropsy showed multisystem involvement. There was clinical and radiographic evidence of widespread sarcoidosis in the other (J.W.). Both patients showed an initial dramatic response to prednisolone. The reported literature of symptomatic muscle sarcoidosis is reviewed briefly.
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