COVID-induced Immune-mediated Necrotizing Myositis: an Atypical Presentation of Rhabdomyolysis with Breakthrough COVID-19 Infection – A Case Report

Anuraag Sah¹, Hardik Fichadiya^1, , Muhammed Atif Masood Noori¹, Arshan Khan², Harshil Fichadiya³, Asnia Latif¹, Maria Khazaei¹ and Michael Zaboski¹

¹Department of Internal Medicine, Rutgers NJMS/ Trinitas Regional Medical Center, Elizabeth, NJ 07202

²Department of Internal Medicine, Ascension St John Hospital, Detroit, MI 48236

³Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ 07740

Cite this paper

Anuraag Sah, Hardik Fichadiya, Muhammed Atif Masood Noori, Arshan Khan, Harshil Fichadiya, Asnia Latif, Maria Khazaei and Michael Zaboski. COVID-induced Immune-mediated Necrotizing Myositis: an Atypical Presentation of Rhabdomyolysis with Breakthrough COVID-19 Infection – A Case Report. American Journal of Medical Case Reports. 2022; 10(6):180-182. doi: 10.12691/AJMCR-10-6-5

Abstract

Immune-mediated necrotizing myopathy (IMNM) is an inflammatory myopathy characterized by proximal muscle weakness and significantly elevated creatinine kinase levels. IMNM occurs primarily in adults and is usually rapidly progressive in nature. It can be seronegative or associated with antibodies against signal recognition peptide (SRP) or hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR). Scarce and rare cases of Immune-mediated necrotizing myopathy have recently been observed in muscle biopsy of COVID-19 patients with similar histological and clinical features of other IMNM with profound proximal muscle weakness and elevated CPK levels. We present a very interesting case of an atypical presentation of IMNM in the presence of COVID-19 infection. Treatment with Remdesivir and dexamethasone resulted in improvement of her symptoms.

Keywords

COVID-19, necrotizing myositis, rhabdomyolysis, breakthrough infection

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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