Report of a patient with inclusion body myositis and CD8+ chronic lymphocytic leukaemia -: post-mortem analysis of muscle and brain

We report a 73-year-old woman with sporadic inclusion body myositis (s-IBM) and a T-cell chronic lymphocytic leukaemia (T-CLL). The s-IBM diagnosis was based on clinical symptoms and muscle biopsy showing inflammatory infiltrates and rimmed vacuoles with 15-18 nm diameter tubulofilamentous inclusions on ultrastructural examination. The inflammatory infiltrates consisted of CD8(+) T-lymphocytes and macrophages. The diagnosis of a CD8(+) T-CLL was based on peripheral blood samples and bone marrow aspiration. The postmortem analysis of skeletal muscle showed fascicular atrophy, which may support a neurogenic component in s-IBM and the analysis of the brain showed only a few diffuse plaques in different cortical regions and occasionally neuritic plaques. A pathophysiological analogy between s-IBM and Alzheimer's has been suggested on the basis of similarities in protein accumulation in muscle of s-IBM patients and brain of Alzheimer's patients. However, Lye were unable to detect any changes suggestive of Alzheimer's disease in the brain of the s-IBM patient presented here.