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Hyperacute muscle weakness in an unusual coexistence of antisignal recognition particle and anti-Mi-2 antibodies
  1. Richard Oluyinka Akintayo1,
  2. Olanrewaju Festus Agbola1,
  3. Abiodun Waliyullah Adeyemo1,
  4. Olufemi Adelowo2
  1. 1Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
  2. 2Department of Medicine, Rheumatology Unit, Lagos State University Teaching Hospital, Lagos, Nigeria
  1. Correspondence to Professor Olufemi Adelowo, femiadelowo2003{at}


Idiopathic inflammatory myopathies are a heterogeneous group of systemic diseases characterised by variable phenotypes of chronic progressive muscle weakness. Myositis-specific antibodies (MSAs) include antibodies to cytoplasmic signal recognition particle (SRP) and various tRNA synthetases as well as the nuclear helicase protein Mi-2. These antibodies are typically found only in a fraction of true myositis cases and they tend to be mutually exclusive. Few cases of coexistence of two MSAs in the same patient have been reported and these cases all involve an antisynthetase antibody coexisting with either anti-SRP or anti-Mi-2 antibody. Peculiar clinical manifestations may be associated with different combinations of MSAs but the rarity of these cases makes their characterisation difficult. We report the first ever case of anti-SRP and anti-Mi-2 copositive polymyositis in a 19-year-old boy who presented with a week history of profound muscle weakness that attained its peak within 24 hours of onset.

  • Connective Tissue Disease
  • Musculoskeletal Syndromes
  • Muscle Disease
  • Immunology
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  • Contributors ROA, OFA and AWA prepared the manuscript. OA critically reviewed the manuscript and all authors agreed on the final draft.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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