Granulomatous inflammatory myopathy associated with myasthenia gravis. A case report and review of the literature.

A 76-year-old woman with a history of granulomatous pulmonary disease presented with myasthenia gravis involving ocular, pharyngeal, and proximal extremity weakness. She responded to prednisone therapy but three years later developed predominantly distal appendicular weakness. Reinvestigation demonstrated a granulomatous inflammatory myopathy.