Immune-mediated necrotizing myopathy following vaccination with the AstraZeneca (AZD1222) COVID-19 vaccine: A case report and brief review

B Ansari; M A Najafi; M Kheradmand; F Najafi; M R Najafi

doi:10.1016/j.neurol.2022.11.009

Immune-mediated necrotizing myopathy following vaccination with the AstraZeneca (AZD1222) COVID-19 vaccine: A case report and brief review

Rev Neurol (Paris). 2023 Jun;179(6):630-635. doi: 10.1016/j.neurol.2022.11.009. Epub 2023 Feb 1.

Authors

B Ansari¹, M A Najafi¹, M Kheradmand¹, F Najafi², M R Najafi³

Affiliations

¹ Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
² Rothman Orthopedics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
³ Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: [email protected].

Abstract

Immune-Mediated Necrotizing Myopathy (IMNM) after vaccination has been reported previously, however it is rare after COVID-19 vaccination. We report the first case of IMNM two weeks after vaccination with the AstraZeneca (AZD1222) COVID-19 vaccine. There was a probable temporal relationship between the COVID-19 vaccination and the development of IMNM due to lack of known causative factors for IMNM. This may have been due to 1) autoimmunity directly caused by the vaccine, 2) exacerbation of autoimmunity triggered by the vaccine or 3) autoimmune syndrome triggered by the vaccine adjutants. Further studies are needed to assess the underlying mechanisms.

Keywords: COVID-19; Myositis; Necrotizing autoimmune myopathy; Rhabdomyolysis; Vaccines.

Publication types

Case Reports
Review

MeSH terms

Autoimmune Diseases* / chemically induced
Autoimmune Diseases* / drug therapy
COVID-19 Vaccines* / adverse effects
COVID-19* / prevention & control
ChAdOx1 nCoV-19
Humans
Muscular Diseases* / chemically induced
Vaccination / adverse effects

Substances

ChAdOx1 nCoV-19
COVID-19 Vaccines