Exposure to an external stimulus (injection, vaccines, silicone, adjuvant) prior to clinical manifestations

The appearance of typical clinical manifestations:

• Myalgia, myositis, or muscle weakness

• Arthralgia and arthritis

• Chronic fatigue, non-restorative sleep, and sleep disorders

• Neurological manifestations (demyelination)

• Cognitive impairment, loss of memory

• Fever, xerostomia

Removal of the initiating agent produces enhancement against the suspected adjuvant

Occurrence of autoantibodies or antibodies against the suspected adjuvant

HLA suspected

Autoimmune disease