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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\u2013190 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.<\/jats:p>","DOI":"10.1136\/bcr-2021-242095","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T12:46:24Z","timestamp":1620737184000},"page":"e242095","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Vaccination as a possible trigger for immune-mediated necrotising myopathy"],"prefix":"10.1136","volume":"14","author":[{"given":"Julia Francesca Bonato","family":"Cavalcanti","sequence":"first","affiliation":[{"name":"Laboratory of Neuromuscular Disease, Department of Neurosciences, Centro Universit\u00e1rio FMABC, Santo Andre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Beatriz Almeida","family":"Silva","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio FMABC, Santo Andre, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5485-7937","authenticated-orcid":false,"given":"Alzira","family":"Alves de Siqueira Carvalho","sequence":"additional","affiliation":[{"name":"Laboratory of Neuromuscular Disease, Department of Neurosciences, Centro Universit\u00e1rio FMABC, Santo Andre, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"2025082803494384000_14.5.e242095.1","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.ncl.2014.04.007","article-title":"Idiopathic inflammatory myopathies","volume":"32","author":"Dimachkie","year":"2014","journal-title":"Neurol Clin"},{"key":"2025082803494384000_14.5.e242095.2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/CND.0000000000000208","article-title":"Case of Anti-Single recognition particle-mediated necrotizing myopathy after influenza vaccination","volume":"19","author":"Mamarabadi","year":"2018","journal-title":"J Clin Neuromuscul Dis"},{"key":"2025082803494384000_14.5.e242095.3","first-page":"21","article-title":"Immune-Mediated necrotizing myopathy","volume":"20","author":"Fernandez","year":"2018","journal-title":"CurrRheumatol Rep"},{"key":"2025082803494384000_14.5.e242095.4","doi-asserted-by":"publisher","DOI":"10.1097\/wco.0000000000000376"},{"key":"2025082803494384000_14.5.e242095.5","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s13223-016-0114-4","article-title":"Post-Vaccination myositis and myocarditis in a previously healthy male","volume":"12","author":"Cheng","year":"2016","journal-title":"Allergy Asthma Clin Immunol"},{"key":"2025082803494384000_14.5.e242095.6","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330908"},{"key":"2025082803494384000_14.5.e242095.7","first-page":"232470961770903","article-title":"Necrotizing autoimmune myopathy: a rare variant of idiopathic inflammatory myopathies","volume":"5","author":"Khan","year":"2017","journal-title":"J Investig Med High Impact Case Rep"},{"key":"2025082803494384000_14.5.e242095.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1402225"},{"key":"2025082803494384000_14.5.e242095.9","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0000000000000065"},{"key":"2025082803494384000_14.5.e242095.10","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-313166"},{"key":"2025082803494384000_14.5.e242095.11","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aww054"},{"key":"2025082803494384000_14.5.e242095.12","doi-asserted-by":"crossref","first-page":"903","DOI":"10.2147\/TCRM.S162931","article-title":"Myopathy due to HMGCR antibodies in adult mimicking muscular dystrophy associated with cancer and statin exposure - 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