Case of anti-single recognition particle-mediated necrotizing myopathy after influenza vaccination

Mansoureh Mamarabadi, Ada Baisre, Megan Leitch, Vivien Hsu, Jaya S. Kanduri, Shan Chen

Research output: Contribution to journalReview article

1 Scopus citations

Abstract

Immune-mediated necrotizing myopathy is a very rare inflammatory disease affecting skeletal muscles. Immune-mediated necrotizing myopathy may be associated with myositis-specific autoantibodies including anti-single recognition particle and anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase, infectious agents (HIV or hepatitis C), other connective tissue disorders (such as scleroderma), and malignancy. We reported a 28-yearold healthy woman presented with subacute onset ascending muscle weakness 2 weeks after an annual influenza vaccination. Cerebral Spinal Fluid study showed normal cell counts with elevated protein and nerve conduction study showed reduced diffuse compound muscle action potential amplitudes suggesting a diagnosis of Guillain-Barré syndrome. Despite treatment using intravenous immunoglobulin, her condition continued to get worse with new bulbar and respiratory muscle weakness. Eventually, the diagnosis of anti-single recognition particle-mediated necrotizing myopathy was made based on elevated creatine kinase, thigh magnetic resonance imaging, muscle biopsy, and positive antibody testing. Our patient responded to the combination of intravenous immunoglobulin, prednisone, and anti-CD20 monoclonal antibody, rituximab.

Original languageEnglish (US)
Pages (from-to)211-216
Number of pages6
JournalJournal of clinical neuromuscular disease
Volume19
Issue number4
DOIs
StatePublished - Jan 1 2018

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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