Case of Anti–Single Recognition Particle–Mediated Necrotizing Myopathy After Influenza Vaccination

Mamarabadi, Mansoureh; Baisre, Ada; Leitch, Megan; Hsu, Vivien; Kanduri, Jaya; Chen, Shan

doi:10.1097/cnd.0000000000000208

Cited by 11 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 12 articles selected, clinical data were extracted for 34 patients with IMNM meeting the inclusion criteria. 7,10,[16][17][18][19][20][21][22][23][24][25] The general features, clinical manifestations, laboratory data, treatments regimen, and outcomes are shown in Tables 1 and 2. With regard to RTX efficacy, 61.8% (21/34) of patients presented a response to RTX.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Rituximab in the treatment of immune-mediated necrotizing myopathy: a review of case reports and case series

Xiong

Yang

Song

et al. 2021

Ther Adv Neurol Disord

View full text Add to dashboard Cite

Immune-mediated necrotizing myopathy (IMNM) is a group of immune-related myopathies characterized by progressive proximal muscle weakness, extremely high serum creatine kinase (CK) levels, and necrotic muscle fibers with a relative lack of inflammation. Treatment of IMNM is challenging, with most cases refractory to high-dose steroids in combination with multiple immunotherapies. The role of rituximab (RTX) for IMNM has been explored in isolated case reports and small series. The aim of this article was to perform a literature review of patients with IMNM treated with RTX and to evaluate RTX efficacy and safety. A total of 34 patients with IMNM were reviewed: 52.9% (18/34) with anti-signal recognition particle (SRP) antibodies and 47.1% (16/34) with anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibodies. Patient age at onset varied from 11 years to 81 years (mean 41 years). The majority of patients presented as a severe proximal muscle weakness and the peak level of CK varied from 3900 IU/L to 56,000 IU/L (mean 18,440 IU/L). Prior to RTX administration, all patients were treated with high-dose steroids and most were treated with multiple immunotherapies. The reason for initiating RTX was that 64.7% (22/34) of patients showed no improvement after previous treatments, and 35.3% (12/34) of patients relapsed when attempting to wean steroids or other immunosuppressive agents. With regard to RTX efficacy, 61.8% (21/34) of patients presented a response to RTX. Our data may support the use of RTX as an effective treatment strategy against IMNM resistant to steroids and multiple immunotherapies. Meanwhile, RTX as a first-line therapy could be a choice in IMNM, particularly in African Americans with anti-SRP antibody-positive subsets. ANA, antinuclear antibody; CK, creatine kinase; HMGCR, 3-hydroxy-3-methylglutaryl-CoA reductase; IMNM, immune-mediated necrotizing myopathy; MAC, membrane attack complex; MHC-I, major histocompatibility complex-I; RTX, rituximab; SRP, signal recognition particle.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Recently, the role of RTX in IMNM had been increasingly assessed in isolated case reports and small series. 7,10,[16][17][18][19][20][21][22][23][24][25] Therefore, we performed a systematic review to evaluate the efficacy and safety of RTX in the treatment of IMNM.…”

Section: Introductionmentioning

confidence: 99%

Rituximab in the treatment of immune-mediated necrotizing myopathy: a review of case reports and case series

Xiong

Yang

Song

et al. 2021

Ther Adv Neurol Disord

View full text Add to dashboard Cite

show abstract

“…Prior infection (most commonly viral infection) or vaccinations (usually influenza vaccination) were also noted in more than 20% of patients with idiopathic inflammatory myopathies (Limaye et al, 2017). A woman was recently reported to have developed anti-SRP-positive IMNM two weeks after being administered influenza vaccination (Mamarabadi et al, 2018). In this case, the disease process and immune response against the influenza A (H3N2) virus may have induced the production of anti-SRP antibodies and worsened her myositis.…”

Section: Discussionmentioning

confidence: 99%

Influenza A (H3N2) infection followed by anti-signal recognition particle antibody-positive necrotizing myopathy: A case report

Iriki

Yamamoto

Senju

et al. 2021

International Journal of Infectious Diseases

View full text Add to dashboard Cite

“…In our study, we reviewed all B-cell therapies for IMNM, and only RTX was identified to be effective (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(18)(19)(20)(21). B-cell depletion therapy with RTX in anti-SRP IMNM is commonly effective.…”

Section: Discussionmentioning

confidence: 99%

“…In previous reports, anti-B-cell therapy, especially rituximab (RTX), an anti-monoclonal CD20 antibody, has been used in IMNM (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In some cases, patients benefited from RTX, while in other cases, patients showed poor response or died from complications, such as infection (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Belimumab for Immune-Mediated Necrotizing Myopathy Associated With Anti-SRP Antibodies: A Case Report and Retrospective Review of Patients Treated With Anti-B-Cell Therapy in a Single Center and Literature

Cui

Tian

et al. 2021

Front. Immunol.

View full text Add to dashboard Cite

BackgroundImmune-mediated necrotizing myopathy (IMNM) is characterized by markedly elevated creatinine kinase and histologically scattered necrotic muscle fibers and generally associated with autoantibodies against signal recognition particle (SRP) or 3-hydroxy-3-methylglutaryl-coA-reductase (HMGCR). Poor clinical response to conventional therapies and relapses commonly occur in severe cases. Anti-B-cell therapies have been used in refractory/relapsing cases.MethodsThe characteristics of a patient with IMNM associated with anti-SRP antibodies including physical examination, laboratory tests, and disease activity assessment were evaluated. Conventional therapy, belimumab treatment schedule, and follow-up data were recorded. Medical records of IMNM patients treated in our department from September 2014 to June 2021 were reviewed to evaluate the efficacy and safety of anti-B-cell therapy for anti-SRP IMNM. A literature review of patients with anti-SRP IMNM treated with anti-B-cell therapies was performed.ResultsWe describe a case of a 47-year-old woman with IMNM associated with anti-SRP antibodies who relapsed twice after conventional therapy but showed good response and tolerance to belimumab at 28 weeks follow-up. In this review, three patients from our department were treated with rituximab. Two of the three patients rapidly improved after treatment. Twenty patients and five retrospective studies were included in the literature review. All patients were administered rituximab as an anti-B-cell drug.ConclusionDespite a lack of rigorous clinical trials, considerable experience demonstrated that anti-B-cell therapy might be effective for patients with IMNM associated with anti-SRP antibodies. Belimumab in association with steroids might be an encouraging option for refractory/relapsing cases.

show abstract

Case of Anti–Single Recognition Particle–Mediated Necrotizing Myopathy After Influenza Vaccination

Cited by 11 publications

References 16 publications

Rituximab in the treatment of immune-mediated necrotizing myopathy: a review of case reports and case series

Rituximab in the treatment of immune-mediated necrotizing myopathy: a review of case reports and case series

Influenza A (H3N2) infection followed by anti-signal recognition particle antibody-positive necrotizing myopathy: A case report

Belimumab for Immune-Mediated Necrotizing Myopathy Associated With Anti-SRP Antibodies: A Case Report and Retrospective Review of Patients Treated With Anti-B-Cell Therapy in a Single Center and Literature

Contact Info

Product

Resources

About