Inclusion Body Myositis with Isolated Dysphagia: An Earlier-stage Diagnosis Using a Surgical Specimen from Cricopharyngeal Myotomy.

A 76-year-old man was admitted to our hospital with progressive dysphagia. His physical and neurological examination results were normal, except for dysphagia. Videofluoroscopy of swallowing demonstrated a cricopharyngeal bar, a highly specific finding for inclusion body myositis (IBM). A cricopharyngeal muscle specimen was obtained during cricopharyngeal myotomy to improve his symptoms. Muscle histopathology successfully led to the diagnosis of IBM. Dysphagia can occasionally precede limb weakness in IBM, and an early histopathological diagnosis using limb muscles is challenging. In such cases, a histopathological evaluation via myotomy may be useful for making an early diagnosis and facilitating appropriate treatment.