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These mutations are associated with limb-girdle muscular dystrophy type 2B, Miyoshi myopathy, asymptomatic hyperCKemia, and distal myopathy with anterior tibial onset.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 16\u00a0year old female presented with myalgia, weakness and dark urine one week after her second BNT162b2 mRNA (Pfizer) vaccine. Initial serum creatine kinase (CK) was measured at 153,000\u00a0IU\/L, eventually up-trending to over 200,000\u00a0IU\/L. However, stable renal function precluded hemodialysis allowing discharge after 10\u00a0days of intravenous (IV) hydration and alkaline diuresis.<\/jats:p>\n                <jats:p>Just two years prior to the current presentation, the patient was hospitalized following Group A Streptococcal pharyngitis infection complicated by rhabdomyolysis. She presented with fatigue, lower extremity weakness, and dark oliguria with CK measuring 984,800\u00a0IU\/L. IV hydration was attempted however hemodialysis was ultimately required throughout her 24-day hospital stay. Her episode was presumed to be idiopathic and no further work-up was performed at that time.<\/jats:p>\n                <jats:p>During the patient\u2019s current hospitalization, she reported similar symptomology (myalgias and weakness) following her first quadrivalent Gardasil vaccine at age 11. No hospitalization was required at that time. A comprehensive workup was now initiated while the patient was being treated for her suspected second or third non-exertional, non-traumatic rhabdomyolysis. Rheumatologic, metabolic, infectious, and endocrinologic workup were all unremarkable. Patient eventually had whole exome sequencing performed which revealed a heterozygous pathogenic variant in the <jats:italic>DYSF<\/jats:italic>\u00a0gene (<jats:italic>DYSF<\/jats:italic>\u00a0c.2643\u2009+\u20091G\u2009&gt;\u2009A) encoding dysferlin. No clinically significant sequelae occurred thus far.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>While there have been reports of symptomatic heterozygote carriers of dysferlinopathies, to our knowledge none have been associated with recurrent rhabdomyolysis after immunogenic stimuli. This unique case presentation highlights the importance of a multi-disciplinary care team, the utility of modern whole-exome gene sequencing, and the future challenges of balancing vaccine risk vs benefit.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12887-022-03561-2","type":"journal-article","created":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T14:04:46Z","timestamp":1661868286000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Recurrent, non-traumatic, non-exertional rhabdomyolysis after immunologic stimuli in a healthy adolescent female: a case report"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7786-7839","authenticated-orcid":false,"given":"Jason","family":"Katz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anatalia","family":"Labilloy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"issue":"2","key":"3561_CR1","doi-asserted-by":"publisher","first-page":"E345","DOI":"10.1002\/humu.20910","volume":"30","author":"M Krahn","year":"2009","unstructured":"Krahn M, B\u00e9roud C, Labelle V, et al. 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