ACTIVE POLYMYOSITIS WITH ONLY BORDERLINE ELEVATION OF THE CREATINE-KINASE LEVEL IN OVERLAP SYNDROME

A female patient of 54 years of age who had been suffering since 1977 from a symmetrically distributed polyarthritis that took a deformative course but without inflammatory bone destruction, developed polymyosi tis additionally from 1989 onwards involving the musculature of the ba ck and pelvic girdle as well as the trunk, followed by invalidity nece ssitating the use of a wheel-chair. During the entire previous history as well as during her hospital stay there was only a slight elevation of creatine kinase level (CK) in the beginning, whereas at all other times there were no abnormal CK values. Polymyositis, however, was dia gnosed on the basis of the clinical pattern with pronounced and proxim ally emphasised myasthenia and muscular atrophy, confirmed by electrom yographic findings with pathological spontaneous activity and myopathi c pattern, as well as by clear findings obtained with regard to muscul ar histology.