Osteomalacic myopathy associated with coexisting celiac disease and primary biliary cirrhosis

To report a patient with coeliac disease [CD] associated with primary biliary cirrhosis [PBC] who presented with myopathy without classical symptoms of CD. Clinical A 42-year-old woman presented with inability to walk and marked loss of motor function. She had elevated liver enzymes with a cholestatic pattern. Antimitochondrial antibody M2 band, anti-endomysial antibody, antigliadin IgA and IgM were positive. Histopathologic findings of the liver revealed PBC and duodenal biopsy was consistent with CD. She was also found to have osteomalacia. She showed slow response to gluten-free diet, but accelerated full recovery with vitamin D replacement. In PBC patients with subclinical CD and myopathy, vitamin D status can provide a basis for treatment

Polymyositis and hepatitis concurrent with breast cancer

To present a rare case of breast cancer associated with both inflammatory muscle disease and liver disease as a paraneoplastic syndrome. Clinical Presentation and Intervention: A woman with breast cancer presented with elevated liver enzymes and progressive proximal muscle weakness. Liver biopsy was consistent with hepatitis and muscle biopsy revealed myositis. The start of corticosteroid therapy was followed by relief of the myopathic symptoms and regression of hepatitis histopathologically. A case of polymyositis and hepatitis associated with breast cancer and their flare-up with recurrence of malignancy is presented. In this case, the temporal relation with malignancy following its concurrent remission and relapse suggests a paraneoplastic mechanism