Muscular Sarcoidosis with Type II Respiratory Failure.

A 66-year-old woman who had been diagnosed with sarcoidosis 1 year prior to identifying a non-caseating granuloma in the nodule in her femur fell into a state of presyncope and had difficulty breathing. She was transported to the emergency department and placed on mechanical ventilation. A blood gas analysis suggested CO2 narcosis. The cause was thought to be ventilatory failure due to muscular sarcoidosis, for which systemic steroid treatment was initiated. Although her consciousness recovered, the ventilatory impairment persisted. This case demonstrates an unusual clinical presentation of life-threatening nodular and myopathy types, characterized by the development of Type II respiratory failure.