Balachandran R Vaidyanathan, Muhamed Abubacker, John Ponugupati
A 64-year-old woman presented with seronegative idiopathic granulomatous myositis, featuring severe bulbar weakness, reversible cardiomyopathy (ejection fraction 20%-25%), hepatic injury, and acute kidney injury. Muscle biopsy confirmed granulomatous inflammation. Treatment with corticosteroids and intravenous immunoglobulin resulted in multi-organ recovery, highlighting the importance of early immunosuppressive therapy.