Necrotizing autoimmune myositis following coronavirus disease 2019 infection: a case report

J Med Case Rep. 2022 Dec 27;16(1):488. doi: 10.1186/s13256-022-03680-5.

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis; however, the exact underlying pathogenesis of severe acute respiratory syndrome coronavirus 2-induced myositis is still unclear.

Case presentation: Herein, we report a rare case of necrotizing autoimmune myositis in a 67-year-old middle eastern male following coronavirus disease 2019 infection, who presented with muscle weakness. The patient had positive anti-NXP2. The diagnosis of necrotizing autoimmune myositis was made according to muscle weakness, increased liver enzymes, electromyography and nerve conduction velocity results, and muscle biopsy. The patient underwent a full malignancy evaluation, which was unremarkable, and was discharged in relatively well condition with a daily dose of 1 mg/kg prednisolone and azathioprine 150 mg (2 mg/kg).

Conclusion: Our report highlights the already known possible protracted sequence of coronavirus disease 2019 infection and the potential for delayed-onset necrotizing myositis.

Keywords: COVID-19; Case report; Muscle weakness; Myalgia; Myositis; SARS-CoV-2.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoimmune Diseases* / complications
  • Autoimmune Diseases* / diagnosis
  • COVID-19* / complications
  • Humans
  • Male
  • Muscle Weakness
  • Myositis* / diagnosis
  • Myositis* / drug therapy
  • Prednisolone
  • SARS-CoV-2

Substances

  • Prednisolone