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He was eventually diagnosed with multisystem inflammatory syndrome in adults (MIS-A) after it was established that he had been suffering from COVID-19 5\u2009weeks prior to presentation. He was started on intravenous immunoglobulins and high-dose corticosteroids, after which symptoms resolved rapidly. MIS-A is a rare but severe complication of COVID-19, whose pathogenesis is insufficiently understood. This case provides further insight into this new disease entity by describing a previously unreported disease progression with severe inflammatory myopathy without elevated creatine kinase.<\/jats:p>","DOI":"10.1136\/bcr-2022-250054","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T11:45:39Z","timestamp":1657539939000},"page":"e250054","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Severe myopathy complicating multisystem inflammatory syndrome in adults (MIS-A) in a young man"],"prefix":"10.1136","volume":"15","author":[{"given":"Alessandro E.","family":"Costa","sequence":"first","affiliation":[{"name":"Division of Internal Medicine, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadine S.","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marten","family":"Trendelenburg","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8008-7411","authenticated-orcid":false,"given":"Max J.","family":"Schunemann","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,7,11]]},"reference":[{"key":"2025082800283933000_15.7.e250054.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6940e1"},{"key":"2025082800283933000_15.7.e250054.2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.10323","article-title":"Characteristics associated with multisystem inflammatory syndrome among adults with SARS-CoV-2 infection","volume":"4","author":"Davogustto","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2025082800283933000_15.7.e250054.3","doi-asserted-by":"crossref","first-page":"305","DOI":"10.14745\/ccdr.v47i78a03","article-title":"Epidemiologic and clinical characteristics of multisystem inflammatory syndrome in adults: a rapid review","volume":"47","author":"Atchessi","year":"2021","journal-title":"Can Commun Dis Rep"},{"key":"2025082800283933000_15.7.e250054.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021680"},{"key":"2025082800283933000_15.7.e250054.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2094"},{"key":"2025082800283933000_15.7.e250054.6","doi-asserted-by":"crossref","first-page":"680813","DOI":"10.3389\/fped.2021.680813","article-title":"Multisystem inflammatory syndrome in children: unique disease or part of the Kawasaki disease spectrum?","volume":"9","author":"Matucci-Cerinic","year":"2021","journal-title":"Front Pediatr"},{"key":"2025082800283933000_15.7.e250054.7","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1038\/s41584-021-00608-z","article-title":"Systemic and organ-specific immune-related manifestations of COVID-19","volume":"17","author":"Ramos-Casals","year":"2021","journal-title":"Nat Rev Rheumatol"},{"key":"2025082800283933000_15.7.e250054.8","unstructured":"CDC . 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Available: https:\/\/www.who.int\/news-room\/commentaries\/detail\/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19 [Accessed 8 Feb 2022]."},{"key":"2025082800283933000_15.7.e250054.10","doi-asserted-by":"crossref","first-page":"3037","DOI":"10.1016\/j.vaccine.2021.01.054","article-title":"Multisystem inflammatory syndrome in children and adults (MIS-C\/A): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data","volume":"39","author":"Vogel","year":"2021","journal-title":"Vaccine"},{"key":"2025082800283933000_15.7.e250054.11","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-020-0367-5"},{"key":"2025082800283933000_15.7.e250054.12","doi-asserted-by":"crossref","DOI":"10.3390\/microorganisms9071393","article-title":"Multisystem inflammatory syndrome in an adult (MIS-A) successfully treated with Anakinra and glucocorticoids","volume":"9","author":"Cattaneo","year":"2021","journal-title":"Microorganisms"},{"key":"2025082800283933000_15.7.e250054.13","article-title":"Rhabdomyolysis as a presentation of 2019 novel coronavirus disease","volume":"12","author":"Suwanwongse","year":"2020","journal-title":"Cureus"},{"key":"2025082800283933000_15.7.e250054.14","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217573"},{"key":"2025082800283933000_15.7.e250054.15","doi-asserted-by":"crossref","first-page":"e392","DOI":"10.1093\/rheumatology\/keab426","article-title":"Multisystem inflammatory syndrome in an adult with involvement of the skin, lymph nodes, muscle, heart, liver and kidneys","volume":"60","author":"Kinter","year":"2021","journal-title":"Rheumatology"},{"key":"2025082800283933000_15.7.e250054.16","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.pediatrneurol.2021.07.015","article-title":"Severe rhabdomyolysis in a child with multisystem inflammatory syndrome: an autoimmune mechanism?","volume":"124","author":"Fabi","year":"2021","journal-title":"Pediatr Neurol"},{"key":"2025082800283933000_15.7.e250054.17","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2021-243112","article-title":"Severe acute inflammatory myositis and rhabdomyolysis in paediatric SARS-CoV-2-associated MIS-C (multisystem inflammatory syndrome in children)","volume":"14","author":"Cassim","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082800283933000_15.7.e250054.18","doi-asserted-by":"crossref","first-page":"716198","DOI":"10.3389\/fcvm.2021.716198","article-title":"Case report: lymphohistiocytic myocarditis with severe cardiogenic shock requiring mechanical cardiocirculatory support in multisystem inflammatory syndrome following SARS-CoV-2 infection","volume":"8","author":"Bemtgen","year":"2021","journal-title":"Front Cardiovasc Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-250054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:28:49Z","timestamp":1756366129000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-250054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":18,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7,11]]},"published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1136\/bcr-2022-250054"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-250054","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}