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Anti-SRP-positive necrotising myopathy is frequently treated as refractory myositis due to its poor responsiveness to steroid monotherapy and conventional immunosuppressive therapies. Therefore, anti-SRP-positive necrotising myopathy differs from immune-mediated myopathy. Although anti-SRP autoantibody is found in only 4\u20136% of patients with idiopathic inflammatory myopathy, the actual proportion of patients with refractory anti-SRP-positive necrotising myopathy is unknown. We describe a patient with multiple comorbidities who had subacute-onset anti-SRP-positive immune-mediated necrotising myopathy (IMNM). After failing steroids, methotrexate and IVIG therapy, she made a considerable recovery with rituximab. She was later diagnosed to have breast malignancy. Malignancy-associated anti-SRP-positive IMNM is rarely reported.<\/jats:p>","DOI":"10.1136\/bcr-2023-254702","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T21:00:50Z","timestamp":1702328450000},"page":"e254702","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Anti-SRP-positive necrotising myopathy concurrent with breast malignancy"],"prefix":"10.1136","volume":"16","author":[{"given":"Tarini","family":"Dandasena","sequence":"first","affiliation":[{"name":"Department of General Medicine, All India Institute of Medical Science-Bhopal, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Ingle","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Science-Bhopal, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Singhai","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Science-Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Saigal","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Science-Bhopal, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"2025082711143216000_16.12.e254702.1","doi-asserted-by":"crossref","DOI":"10.1177\/1759720X19886494","article-title":"New insights into the treatment of Myositis","volume":"12","author":"Glaubitz","year":"2020","journal-title":"Ther Adv Musculoskelet Dis"},{"key":"2025082711143216000_16.12.e254702.2","unstructured":"Greenberg SA , Amato AA . 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