Scleromyositis: about a case of early diagnosis in Lomé and review of the literature

Introduction: Scleromyositis (SM) represents an overlap syndrome between scleroderma and inflammatory myopathy. It is the most common of the overlapping syndromes. Observation: The authors report a case of scleromyositis in a 26-year-old woman. The diagnosis was facilitated by the presence of myalgia in the anterior aspect of the left leg, as detected by magnetic resonance imaging (MRI) of the left thigh, which revealed edema involving the intermedial vastus and the medium gluteal muscles. Muscle enzymes were normal, but electroneuromyogram revealed a neuropathic pattern. Furthermore, antinuclear antibodies (ANA) were found to be positive using indirect immunofluorescence on Hep 10-20 slides, with a titer of 1/160, a speckled appearance and anti-polymyositis/scleroderma antibodies were identified. The patient was treated with corticosteroids and then immunosuppressants, with a favorable clinical response. Conclusion: Muscle MRI can facilitate the diagnosis of scleromyositis in countries where access to muscle biopsy is challenging.