Fibrosing alveolitis and polymyositis.

There have been five reported instances of polymyositis and diffuse fibrosing alveolitis in the one patient (Mills and Mathews, 1956; Goldfischer and Rubin, 1959; Hyun, Diggs, and Toone, 1962; Pace, Decker, and Martin, 1963; Sandbank, Grunebaum, and Katzenellenbogen, 1966). Additional but less definite cases were reported by Pace et al. (1963), in which the pulmonary changes were more suggestive of the arteritis of systemic sclerosis, and by Peralta and Carril (1962), in which there was no histological confirmation of alveolitis. We suspect that some instances of coexisting polymyositis and fibrosing alveolitis are unrecognized because both conditions are treated with corticosteroid drugs (Scadding and Hinson, 1967; Rose and Walton, 1966), which could mask the manifestations of the coexisting condition or result in myositis being diagnosed as a 'steroid myopathy'. We present a patient with fibrosing alveolitis who was not treated with corticosteroids; florid polymyositis was noted at necropsy.