Evidence map›Paper›PMID 42631007›Full record

ArticleJournal of community hospital internal medicine perspectives2026

A Case of Anti-SRP Immune-mediated Necrotizing Myopathy Following Suspected Coxsackie B4 Infection: Exploring a Viral Trigger Hypothesis.

Marwan Ahmed, Ruba Salameh, Soziema Salia, Brent T Harris, Christopher J Haas, Anees Siddiqi

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In one paragraph

Article in Journal of community hospital internal medicine perspectives, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Marwan AhmedDepartment of Internal Medicine, MedStar Health, Baltimore, MD, USA.
Ruba SalamehDepartment of Internal Medicine, MedStar Health, Baltimore, MD, USA.
Soziema SaliaDepartment of Internal Medicine, MedStar Health, Baltimore, MD, USA.
Brent T HarrisDepartment of Pathology, Georgetown University Hospital, Washington, DC, USA.
Christopher J HaasDepartment of Internal Medicine, MedStar Health, Baltimore, MD, USA.
Anees SiddiqiDepartment of Internal Medicine, MedStar Health, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Immune-mediated necrotizing myopathy (IMNM) is a rare subtype of idiopathic inflammatory myopathies that can present with rhabdomyolysis. We report a 43-year-old woman with rapidly progressive proximal muscle weakness following a flu-like illness. Laboratory evaluation revealed markedly elevated creatine kinase (22,207 U/L) and transaminases, with positive anti-signal recognition particle (SRP) and Coxsackie B4 antibodies. Muscle biopsy demonstrated extensive necrosis, regeneration, and endomysial lymphocytic infiltration, confirming IMNM. The patient was treated with intravenous methylprednisolone, IVIG, and rituximab, followed by oral steroid taper and mycophenolate. At six-month follow-up, she showed significant clinical and biochemical improvement. This case highlights a potential viral-triggered autoimmune mechanism, suggesting that Coxsackie B4 infection may initiate or amplify anti-SRP-mediated immune muscle injury. Greater awareness of viral associations may aid early diagnosis and targeted therapy of IMNM.

Indexed as

CoxsackieCreatine kinaseIdiopathic inflammatory myopathyImmune-mediated necrotizing myositisRhabdomyolysis

Identifiers

PMID42631007
PMCPMC13496469

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.