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Do you consider immunosuppression in patients with a history of Sjogren's disease and clinical features of inclusion body myositis?  

Pt with long standing history of Sjogren's (+SSA) and muscle weakness (muscle biopsy showed chronic myopathic changes with Lymphocytic inflammation and femur MRI with fatty infiltration of quadriceps and vastus lateralis muscles), CK normal at 160 U/L