Post-vaccination myositis and myocarditis in a previously healthy male

Table 2 Criteria suggested ASIA diagnosis

	Exposure to an external stimuli (Infection, vaccine, silicone, adjuvant) prior to clinical manifestations
Major criteria	The appearance of ’typical’ clinical manifestations:
	Myalgia, Myositis or muscle weakness
	Arthralgia and/or arthritis
	Chronic fatigue, un-refreshing sleep or sleep disturbances
	Neurological manifestations (especially associated with demyelination)
	Cognitive impairment, memory loss
	Pyrexia, dry mouth
	Removal of inciting agent induces improvement
	Typical biopsy of involved organs
Minor criteria	The appearance of autoantibodies or antibodies directed at the suspected adjuvant
	Other clinical manifestations (i.e. irritable bowel syn.)
	Specific HLA (i.e. HLA DRB1, HLA DQB1)
	Evolvement of an autoimmune disease (i.e. MS, SSc)

For the diagnosis of ASIA, the presence of at least 2 major or 1 major and 2 minor criteria must be apparent. Table reprinted from Journal of Autoimmunity, vol. 36(1), Yehuda Shoenfelda and Nancy Agmon-Levin, ‘ASIA’—Autoimmune/inflammatory syndrome induced by adjuvants, pages 4–8, Copyright 2011, with permission from Elsevier

ISSN: 1710-1492