PT  - JOURNAL ARTICLE
AU  - Julia Francesca Bonato Cavalcanti
AU  - Maria Beatriz Almeida Silva
AU  - Alzira Alves de Siqueira Carvalho
TI  - Vaccination as a possible trigger for immune-mediated necrotising myopathy
AID  - 10.1136/bcr-2021-242095
DP  - 2021 May 01
TA  - BMJ Case Reports
PG  - e242095
VI  - 14
IP  - 5
4099  - http://casereports.bmj.com/content/14/5/e242095.short
4100  - http://casereports.bmj.com/content/14/5/e242095.full
SO  - BMJ Case Reports2021 May 01; 14
AB  - Immune-mediated necrotising myopathy is a rare autoimmune myopathy characterised by severe progressive muscle weakness, elevated levels of creatine kinase (CK), and necrosis with minimal inflammatory cell infiltration on muscle biopsy. We report a case of a previously healthy 42-year-old woman who presented with progressive muscle weakness 2 weeks after immunisation for yellow fever, tetanus/diphtheria and hepatitis B. Her symptoms started from the lower limbs and progressed to the upper limbs and cervical region associated with dysphagia, making her wheelchair bound. Electromyography showed a myopathic pattern, with a CK level of 12.177 U/L (reference value: 26–190 U/L), and biceps brachial muscle biopsy confirmed necrosis and regeneration fibres. The immunoblot test was positive for antisignal recognition particle. She was successfully treated with prednisone (1 mg/kg/day). Although considered safe, vaccines may cause allergic reactions or trigger autoimmune disorders. Currently, a causal relationship between them cannot be established.