ABSTRACT
Resumen El SARS-CoV-2, la causa de la enfermedad por el nuevo coronavirus de 2019 (COVID-19), ha demostrado producir una variedad de manifestaciones extra pulmonares. La rabdomiólisis debida a la infección por SARS-CoV-ha sido reportada principalmente en el curso temprano de la enfermedad. En el pre sente informe, presentamos el caso de una paciente con infección confirmada por SARS-CoV-2 que se recuperó de neumonía por COVID-19 y posteriormente desarrolló una rabdomiólisis de inicio tardío que fue manejada con éxito con corticosteroides orales e hidratación enérgica durante el curso de la hospitalización. El reconocimiento y diferenciación oportuna de esta subdiagnosticada entidad y las manifestaciones constitucionales usuales du rante el COVID-19, podrían ayudar a prevenir y tratar tempranamente complicaciones posteriores potencialmente mortales.
Abstract SARS-CoV-2, the cause of 2019 novel coronavirus disease (COVID-19), has shown to produce a variety of extrapulmonary manifestations. Rhabdomyolysis due to SARS-CoV-2 infection has been reported mainly in the early course of the disease. In this report, we present the case of a female patient with confirmed SARS-CoV-2 infection who recovered from respiratory compromise and developed a late-onset rhabdomyolysis successfully managed with oral corticoste roids and aggressive hydration. Prompt recognition of this underdiagnosed entity could help prevent subsequent life-threatening complications.
Subject(s)
Humans , Female , Rhabdomyolysis/diagnosis , Rhabdomyolysis/etiology , COVID-19 , SARS-CoV-2ABSTRACT
SARS-CoV-2 infection has a wide spectrum of clinical manifestations secondary to the impairment of different organs, including kidney. Rhabdomyolysis is produced by disintegration of striated muscle and the liberation of its contents to the extracellular fluid and bloodstream. This may produce hydro electrolytic disorders and acute kidney injury. We report a 35-year-old female with a history of SARS-CoV-2 infection who was hospitalized because of respiratory failure and developed renal failure. The etiologic study showed elevated total creatine kinase levels and a magnetic resonance imaging confirmed rhabdomyolysis. The patient required supportive treatment with vasoactive drugs, mechanic ventilation and kidney replacement therapy. She had a favorable evolution with resolution of respiratory failure and improvement of kidney function.
Subject(s)
Humans , Female , Adult , Rhabdomyolysis/diagnosis , Rhabdomyolysis/virology , Acute Kidney Injury/diagnosis , Acute Kidney Injury/virology , COVID-19/complications , Renal Replacement TherapyABSTRACT
Abstract Bee venom is a natural toxin composed of several peptides. Massive envenoming causes severe local and systemic reactions. We report two cases of severe bee envenomation, of which one was fatal. We also describe clinical characteristics and immune markers. Both victims suffered from respiratory distress, renal failure, rhabdomyolysis, and shock. They required invasive mechanical ventilation, vasoactive drugs, and renal replacement therapy. Moreover, serum levels of chemokines, cytokines, and cell-free circulating nucleic acids demonstrated an intense inflammatory process. Massive envenoming produced systemic injury in the victims, with an uncontrolled inflammatory response, and a more significant chemotactic response in the fatal case.
Subject(s)
Animals , Rhabdomyolysis/diagnosis , Rhabdomyolysis/etiology , Bee Venoms , Insect Bites and Stings/complications , Bees , Brazil , BiomarkersABSTRACT
ABSTRACT Introduction: The number of incident and prevalent patients on dialysis has increased, as well as the number of candidates for renal transplantation in Brazil, without a proportional increase in the number of organ donors. The use of expanded kidneys, as to renal function, may be an alternative to increase the supply of organs. Objective: to discuss the feasibility of using expanded kidneys for renal function, which are in severe acute renal injury. Methods: All cases of renal transplantation of deceased donors performed at the Hospital das Clínicas de Botucatu of UNESP, from January 2010 to June 2018, totaling 732 cases were evaluated. Cases with final donor creatinine greater than 6 mg/dL were selected. Results: four patients were selected, of whom all donors were in severe acute kidney injury (AKI). These donors presented rhabdomyolysis as a probable cause of severe AKI, were young, with no comorbidities and had decreased urinary volume in the last 24 hours. The clinical evolution of all the recipients was satisfactory, with a glomerular filtration rate after transplantation ranging from 48 to 98 mL/min/1.73 m2. Conclusion: this series of cases shows the possibility of using renal donors in severe AKI, provided the following are respected: donor age, rhabdomyolysis as the cause of AKI, and implantation-favorable biopsy findings. Additional studies with better designs, larger numbers of patients and longer follow-up times are needed.
RESUMO Introdução: O número de pacientes incidentes e prevalentes em diálise tem aumentado, assim como o número de candidatos ao transplante renal no Brasil, sem um aumento proporcional do número de doadores de órgãos. O uso de rins expandidos, quanto à função renal, pode ser uma alternativa para aumentar a oferta de órgãos. Objetivo: discutir a viabilidade do uso de rins expandidos quanto à função renal, que estejam em lesão renal aguda severa. Métodos: foram avaliados todos os casos de transplante renal de doador falecido realizados no Hospital das Clínicas de Botucatu da UNESP, de janeiro de 2010 a junho de 2018, totalizando 732 casos. Selecionou-se os casos com creatinina final do doador maior do que 6 mg/dL. Resultados: quatro pacientes foram selecionados, dos quais todos os doadores estavam em lesão renal aguda (LRA) severa. Esses doadores apresentavam rabdomiólise como provável causa de LRA severa, eram jovens, sem comorbidades e apresentavam diminuição de volume urinário nas últimas 24 horas. A evolução clínica de todos os receptores foi satisfatória, com taxa de filtração glomerular após o transplante variando entre 48 a 98 mL/min/1,73m2. Conclusão: essa série de casos mostra a possibilidade de utilização de doadores renais em LRA severa, desde que respeitadas as condições seguintes: idade do doador, rabdomiólise como causa de LRA e achados de biópsia favoráveis à implantação. Estudos adicionais com melhores desenhos, maior número de pacientes e maiores tempos de seguimento são necessários.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Rhabdomyolysis/diagnosis , Tissue Donors/statistics & numerical data , Kidney Transplantation/methods , Delayed Graft Function/diagnosis , Acute Kidney Injury/surgery , Research Design , Brazil/epidemiology , Cadaver , Feasibility Studies , Retrospective Studies , Renal Dialysis/statistics & numerical data , Kidney Transplantation/statistics & numerical data , Outcome Assessment, Health Care , Creatinine/blood , Delayed Graft Function/etiology , Acute Kidney Injury/etiology , Glomerular Filtration Rate/physiology , Graft Survival/physiology , Kidney/physiopathologySubject(s)
Humans , Animals , Male , Female , Adult , Rhabdomyolysis/etiology , Rhabdomyolysis/epidemiology , Seafood/adverse effects , Foodborne Diseases/etiology , Foodborne Diseases/epidemiology , Rhabdomyolysis/diagnosis , Brazil/epidemiology , Diagnosis, Differential , Myalgia/etiology , Myalgia/therapy , Fishes , Fluid Therapy , Foodborne Diseases/diagnosis , Analgesics, Opioid/therapeutic useABSTRACT
Rhabdomyolysis is a pathology that rarely has causes in the perioperative period, where it has been commonly related as a complication of malignant hyperthermia, prolonged patient positioning with intraoperative muscle compression, in the postoperative period of bariatric surgery and in children. The purpose of this review is to present the case of a 49 year-old male patient, who underwent limb salvage surgery for treatment of a left femur osteosarcoma, with reconstruction via bone transplant and joint prosthesis. During the procedure hyperkalemia and elevation of Creatine-Phosphokinase (CPK) enzyme levels where detected, without changes compatible with renal failure, which required repeated treatment to normalize and that, after ruling out other causes, it was attributed to skeletal muscle destruction during the procedure. Rhabdomyolysis is a phenomenon inherent to this sort of procedures and may manifest initially as laboratory findings and that, if not diagnosed in time, may lead to fatal arrhythmias and acute renal failure.
La rabdomiólisis es una patología que rara vez tiene origen en el período perioperatorio, donde comúnmente se le ha relacionado como complicación de la hipertermia maligna, de decúbitos prolongados con compresión muscular intraoperatoria, del posoperatorio de la cirugía bariátrica y en niños. El objetivo de este trabajo es presentar el caso de un hombre de 49 años, sometido a resección de un osteosarcoma de fémur izquierdo con reconstrucción mediante trasplante óseo y prótesis articular, durante el cual se detectan hiperpotasemia y aumento de la Creatin-Fosfokinasa (CPK), sin alteraciones compatibles con fallo renal, que requirió reiterados tratamientos para la normalización de los valores de kalemia, y que tras descartar otras causas se atribuyó a la destrucción de musculoesquelético durante el procedimiento. La rabdomiólisis es un fenómeno inherente a este tipo de procedimientos y puede manifestarse inicialmente con alteraciones analíticas que, de no ser diagnosticadas en tiempo y forma, pueden llevar a arritmias fatales y fallo renal agudo.
Subject(s)
Humans , Male , Adult , Rhabdomyolysis/diagnosis , Rhabdomyolysis/etiology , Bone Neoplasms/surgery , Osteosarcoma/surgery , Orthopedic Procedures/adverse effects , Creatine Kinase/analysis , Renal Insufficiency , Femur/surgery , Hyperkalemia/etiology , Intraoperative ComplicationsABSTRACT
RESUMO A rabdomiólise é um processo de destruição muscular com manifestações clínicas variáveis. Em pacientes pediátricos, tem como principal etiologia as doenças infecciosas. Apresentamos o caso de uma adolescente previamente saudável, que foi admitida ao nosso pronto-socorro com histórico de 4 dias com mialgia, fraqueza muscular e urina escura. Na avaliação inicial, apresentava-se desidratada. Os exames de sangue revelaram insuficiência renal aguda e aumento de enzimas musculares. A paciente foi transferida para nossa unidade de terapia intensiva pediátrica. Foi realizado tratamento clínico para correção da desidratação e das consequências iônicas e metabólicas da insuficiência renal. Em razão da oligúria, deu-se início à terapia de substituição renal. A investigação etiológica revelou um defeito da betaoxidação. Sabe-se que doenças metabólicas podem provocar rabdomiólise. A destruição muscular deve ser identificada precocemente, para evitar suas potenciais consequências. Em geral, o tratamento da rabdomiólise é conservador, embora em algumas situações seja necessária uma abordagem mais invasiva.
ABSTRACT Rhabdomyolysis is a process of muscle destruction that can present with varying clinical manifestations. In pediatric patients, its main etiology is infectious diseases. We present a previously healthy adolescent who was admitted to our emergency department with a four-day history of myalgia, muscle weakness and dark urine. At presentation, she was dehydrated. Blood analysis revealed acute renal failure and increased muscular enzymes. She was transferred to our pediatric intensive care unit. Medical therapies for correction of dehydration and the ionic and metabolic consequences of renal failure were performed. Due to oliguria, renal replacement therapy was initiated. An etiological investigation revealed a beta-oxidation defect. Metabolic diseases are a known cause of rhabdomyolysis. Muscular destruction should be diagnosed early in order to avoid its potential consequences. Generally, the treatment of rhabdomyolysis is conservative, although in some situations, a more invasive approach is needed.
Subject(s)
Humans , Female , Adolescent , Rhabdomyolysis/etiology , Acute Kidney Injury/diagnosis , Metabolic Diseases/diagnosis , Oliguria/etiology , Oliguria/therapy , Rhabdomyolysis/diagnosis , Renal Replacement Therapy , Acute Kidney Injury/therapy , Metabolic Diseases/complicationsABSTRACT
Rabdomiólise é uma condição aguda com lesão muscular esquelética e liberação de toxinas produzidas pelos miócitos. A apresentação clínica é variada (desde elevações assintomáticas de marcadores de injúria muscular, com a creatina fosfoquinase (CPK), até distúrbios hidroeletrolíticos graves com ou sem insuficiência renal aguda. As etiologias envolvem desde medicamentos como atividades físicas extenuantes. O diagnóstico é clínico-laboratorial, chamando a atenção para níveis aumentados de enzimas musculares, especialmente a reatinofosfoquinase. A principal complicação clínica é a insuficiência renal aguda e o diagnóstico precoce é fundamental para a instituição de medidas terapêuticas eficazes. Relatamos o caso de um paciente jovem, com rabdomiólisepós exercício físico (musculação), com altos índices de reatinofosfoquinase (239.000U/L), sem evolução para insuficiência renal aguda (IRA), contrariamente ao esperado pelos valores isolados de reatinofosfoquinase.
Rhabdomyolysis is a acute condition with muscle injury and liberation of toxins produced by myocytes. The clinical presentation is wide (from asymptomatic elevations in laboratorial markers of muscle injury, like creatine kinase (CK), to severe electrolyte disturbances with or without acute renal failure). The etiologies involve from medications to strenuous physical activity. The diagnosis is clinical and laboratorial, which have attention to the increased levels of muscle enzymes, especially the CPK. The main clinical complication is acute renal failure and early diagnosis is critical for the establishment of effective therapeutic measures. We report the case of a young patient with rhabdomyolysis after exercise (weightlifting), with high levels of CPK (239.000U/L) without denvelopment to acute renal failure (ARF), contrary to the expected with isolated values of CPK only.
Subject(s)
Humans , Male , Acute Kidney Injury/prevention & control , Rhabdomyolysis/diagnosis , Rhabdomyolysis/therapy , Myalgia , Physical ExertionABSTRACT
Rhabdomyolysis results from acute necrosis of skeletal muscle fibers and consequent leakage of muscle constituents into the circulation. It ranges from an asymptomatic state to a severe condition associated with extreme elevations in creatine kinase and acute renal failure. Reported etiologies of rhabdomyolysis include alcohol abuse, drugs, muscle trauma and muscle overexertion. Less common causes include muscle enzyme deficiencies, electrolyte abnormalities, infectious causes, toxins and endocrine disorders. Hypokalemia is a rare cause of rhabdomyolysis. We report six patients aged 31 to 57 years (three women) with a severe hypokalemic rhabdomyolysis, secondary to chronic diarrhea in two patients, treatment with loop diuretics in one and Gitelman syndrome in three. Rhabdomyolysis may be underdiagnosed in the context of hypokalemia, because the neuromuscular symptoms can be attributed solely to the electrolyte disorder.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Gitelman Syndrome/etiology , Hypokalemia/complications , Rhabdomyolysis/etiology , Gitelman Syndrome/diagnosis , Hypokalemia/diagnosis , Rhabdomyolysis/diagnosis , Severity of Illness IndexABSTRACT
Acute renal failure is an important complication of falciparum malaria. Though rhabdomyolysis has been reported in falciparum malaria occasionally, its role in the causation of acute renal failure in malaria has not been investigated. Therefore, we have undertaken this research to study skeletal involvement in malaria and to correlate it to acute renal failure. Material and Methods: Sixty patients of malaria were included in this study. Of them there were 23 (38.3%) patients of cerebral malaria with renal failure (Group A), 15 (25.0%) patients with cerebral malaria without renal failure (Group B), and 22 (36.6%) patients of uncomplicated malaria (Group C). The diagnosis of malaria was done by Giemsa stained peripheral blood smear or QBC. All patients were subjected to detailed investigations. In addition serum creatine kinase (CK) and myoglobin (Mb) levels were estimated. Muscle biopsy was performed in 10 cases and tissue specimens were stained with hematoxylin-eosin stain. Results: The mean serum CK level (IU/L) in Group A, Group B and Group C were 406.8 ± 290.8 IU/L, 127.4 ± 112.1 IU/L, 110.4 ± 99.0 IU/L respectively. The mean serum Mb level (ng/ml) in Group A, Group B and Group C were 344.6 ± 260.1 ng/ml, 103.9 ± 97.0 ng/ml and 45.9 ± 45.4 ng/ml respectively. Serum Mb concentration was significantly high in cerebral malaria with renal failure. Significant correlation had been observed between serum CK and Mb level (r = 0.71 for 60 patents; p = <0.001; 95% Cl = 0.55 to 0.82). Serum CK correlated well with parasitemia (r = 0.56, p<0.001).There was a significant correlation between serum Mb concentration with the simultaneous serum creatinine level (r = 0.46; p value = 0.001). There was significant association observed between muscle injury and renal failure (Chi square =6.72, p = 0.01). There was no evidence of muscle necrosis in any of the biopsy specimens examined. Conclusion: The present study showed that biochemical evidence of muscle injury was found in patients of falciparum malaria with renal failure. Therefore myoglobin may have a pathogenetic role in malarial acute renal failure.
Subject(s)
Acute Kidney Injury/epidemiology , Acute Kidney Injury/etiology , Adult , Female , Humans , Malaria, Falciparum/complications , Malaria, Falciparum/epidemiology , Male , Middle Aged , Renal Insufficiency/epidemiology , Renal Insufficiency/etiology , Rhabdomyolysis/diagnosis , Rhabdomyolysis/epidemiology , Rhabdomyolysis/etiologyABSTRACT
La rabdomiólisis se caracteriza por la destrucción de células musculares esqueléticas con liberacióndel contenido celular a la sangre. Sus causas son múltiples, y si bien una de las más frecuentes es el esfuerzo físicoextenuante, hay casos reportados tras practicar ejercicios de baja intensidad. Objetivo: reportar cuatro casos de rabdomiólisisinducida por ejercicio de baja intensidad. Pacientes y método: estudio descriptivo de una serie de cuatrocasos de rabdomiólisis inducida por ejercicio de baja intensidad, internados en un servicio de clínica médica entrelos años 2010 y 2012. Resultados: relación hombre/mujer 3/1, edad media 45.25 años (rango 29-58), media deduración de los síntomas hasta la consulta dos días (rango 1-3). El dolor fue el síntoma más relevante. Dos pacientespresentaron insuficiencia renal aguda con una media de duración de cuatro días (3-5). El tiempo medio hasta lanormalización de los valores de CPK fue de 8.75 días. La CPK media fue de 22.928,5 U/l (rango 1.415-65.672).Los cuatro pacientes recibieron hidratación parenteral vigorosa con solución salina y tuvieron buena evolución clínica.Conclusión: es importante considerar el diagnóstico de rabdomiólisis en pacientes que consultan por síntomasmusculares luego del ejercicio, incluso si éste fue de baja intensidad, pero ante la presencia de factores de riesgocomo hipokalemia, hidratación inadecuada, sudoración excesiva, temperatura ambiente y humedad elevadas. Elpronóstico de la rabdomiólisis es bueno cuando el cuadro es tratado en forma temprana.
Rhabdomyolysis is a syndrome characterised by the destruction of skeletal muscle, and release of cellular contentsinto the circulation. The causes vary; one of the most common causes is strenuous physical exercise, but there are reportsof the syndrome after practicing low-intensity exercises. Objective: to report four cases of low intensity exercise-inducedrhabdomyolysis. Patients and methods: descriptive study of a series of four cases with low intensity exercise-inducedrhabdomyolysis, admitted to the hospital between 2010 and 2012. Results: male/female ratio 3/1, mean age 45.25 years(range 29-58), mean duration of symptoms before consultation two days (range 1-3). The most important symptom waspain. Two patients presented with acute renal failure with a mean duration of four days (3-5). The average time untilthe normalization of CPK values was 8.75 days. The average CPK was 22,928.5 U/l (range 1,415-65,672). All patients creareceivedaggressive hydration with intravenous normal saline infusión, and had good clinical outcome. Conclusion: thediagnosis of rhabdomyolysis must be considered in patients who present with muscle symptoms after exercise, even if it wasof low intensity, especially in the presence of risk factors such as hypokalemia, inadequate hydration, excessive sweating, hotand humid weather. The prognosis of rhabdomyolysis is good when it is treated early.
Subject(s)
Humans , Adult , Exercise , Rhabdomyolysis/diagnosis , Acute Kidney Injury , Internal MedicineABSTRACT
PURPOSE: Acute kidney injury (AKI) caused by hypothyroidism-induced rhabdomyolysis is a rare and potentially life-threatening syndrome. The aim of this study was to investigate the clinical characteristics of such patients. MATERIALS AND METHODS: We retrospectively analyzed five patients treated at the Second Affiliated Hospital of Chongqing Medical University with AKI secondary to hypothyroidism-induced rhabdomyolysis from January 2006 to December 2010. RESULTS: Of the five cases reviewed (4 males, age range of 37 to 62 years), adult primary hypothyroidism was caused by amiodarone (1 case), chronic autoimmune thyroiditis (1 case), and by uncertain etiologies (3 cases). All patients presented with facial and lower extremity edema. Three patients presented with weakness, while two presented with blunted facies and oliguria. Only one patient reported experiencing myalgia and proximal muscle weakness, in addition to fatigue and chills. Creatine kinase, lactate dehydrogenase, and renal function normalized after thyroid hormone replacement, except in two patients who improved through blood purification. CONCLUSION: Hypothyroidism should be considered in patients presenting with renal impairment associated with rhabdomyolysis. Moreover, further investigation into the etiology of the hypothyroidism is warranted.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Acute Kidney Injury/etiology , Amiodarone/adverse effects , Creatine Kinase/blood , Hypothyroidism/complications , Kidney Function Tests , L-Lactate Dehydrogenase/blood , Retrospective Studies , Rhabdomyolysis/diagnosis , Thyroiditis, Autoimmune/complications , Treatment Outcome , Vasodilator Agents/adverse effectsABSTRACT
La rabdomiolisis constituye un síndrome infrecuente con elevada morbimortalidad y de etiología variada. La causa infecciosa representa un 25 por ciento de las rabdomiolisis postquirúrgica. Presentamos el caso de un paciente masculino de 21 años, cursando postquirúrgico de reparación artroscópica de labrum por luxación recidivante de hombro. A las doce horas postquirúrgicas se establece falla renal, con anuria e incremento de urea y creatinina. Elevación de encimas musculares, Creatinfosfocinasa (CPK) y Lactatodeshidrogenasa (LDH). Presentando edema regional en zona quirúrgica con incremento del dolor. Se realizan múltiples toilettes quirúrgicos, con cultivos que desarrollan Bacillus cereus; se confirma el diagnóstico por anatomía patológica. Paciente ingresa en hemodiálisis, se instaura tratamiento antibiótico específico, presentando una evolución favorable. El diagnóstico de esta patología requiere un alto índice de sospecha y exige un tratamiento enérgico, tendiente a evitar sus complicaciones.
Subject(s)
Young Adult , Shoulder Joint/surgery , Shoulder Joint/pathology , Arthroscopy/adverse effects , Rhabdomyolysis/diagnosis , Anti-Bacterial Agents/therapeutic use , Edema , Infections , Postoperative Complications , Renal InsufficiencySubject(s)
Acute Kidney Injury/etiology , Acute Kidney Injury/physiopathology , Acute Kidney Injury/therapy , Combined Modality Therapy , Critical Illness , Disease Progression , Electric Injuries/complications , Electric Injuries/diagnosis , Emergency Service, Hospital , Fatal Outcome , Humans , Injury Severity Score , Male , Rhabdomyolysis/complications , Rhabdomyolysis/diagnosis , Young AdultABSTRACT
Rabdomiólise é uma síndrome que afeta a musculatura estriada esquelética que apresenta um amplo espectro de sintomas clínicos e achados laboratoriais. Decorre, basicamente, da lesão das células musculares, com liberação do conteúdo citoplasmático para a corrente sanguínea e devido a essa situação gerar complicações com alto potencial de morbi-mortalidade, como insuficiência renal aguda. O diagnóstico, baseado em suspeita clínica e em achados laboratoriais, deve ser feito o mais precocemente possível, para buscar a redução das complicações inerentes à síndrome. É relatado caso de paciente com rabdomiólise secundária a exercício físico intenso, que apresentou resolução, sem repercussões de maior morbidade com o tratamento adequado.
Rhabdomyolysis is a syndrome that affects the skeletal striated musculature and presents a wide range of clinical symptoms and laboratory findings. It is primarily a result of injury to muscle cells with release of the cytoplasmic content into the blood flow and thereby generating complications with a high risk of morbidity and mortality including acute kidney failure. The diagnosis, based on clinical suspicion and laboratory findings, must be made as early as possible in order to reduce the complications inherent in the syndrome. Here we report the case of a patient with rhabdomyolysis secondary to intense physical effort, which was successfully resolved with proper treatment without any repercussions of major morbidity.
Subject(s)
Humans , Male , Adult , Muscle, Skeletal/injuries , Muscle, Skeletal/pathology , Rhabdomyolysis/complications , Rhabdomyolysis/diagnosis , Rhabdomyolysis/etiology , Rhabdomyolysis/mortality , Rhabdomyolysis/pathology , Rhabdomyolysis/therapy , Creatine Kinase , Physical ExertionABSTRACT
Las causas de rabdomiólisis suelen dividirse en traumáticas (por trauma directo o compresión) y no traumáticas; en este último grupo se engloban las relacionadas con el ejercicio.
Subject(s)
Exercise , Rhabdomyolysis/diagnosis , Rhabdomyolysis/epidemiology , Rhabdomyolysis/etiology , Athletic Injuries/diagnosisABSTRACT
A 29-year-old man was admitted to hospital with fever, myalgia, and sore throat. Initial laboratory findings were compatible with acute hepatitis; he was positive for the serologic marker for acute hepatitis A. On the 3rd day of admission, in spite of normalization of body temperature and a reduction in serum liver enzyme levels, serum levels of creatinine phosphokinase had increased up to 16,949 U/L. The patient recovered with supportive therapy and was discharged on the 12th day. We report a case of acute hepatitis A complicated by rhabdomyolysis during hospitalization.
Subject(s)
Adult , Humans , Male , Acute Disease , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Creatine Kinase/blood , Hepatitis A/complications , Hospitalization , Rhabdomyolysis/diagnosisSubject(s)
Aged , Female , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Myotonia/chemically induced , Rhabdomyolysis/chemically induced , Simvastatin/adverse effects , Electromyography , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypercholesterolemia/drug therapy , Myotonia/physiopathology , Needles , Rhabdomyolysis/diagnosis , Rhabdomyolysis/physiopathology , Simvastatin/therapeutic useABSTRACT
Salmonella infection can cause an asymptomatic intestinal carrier state or clinical diseases such as enterocolitis presenting abdominal pain, fever, vomiting, or diarrhea. Salmonella usually invades Peyer's patch of terminal ileum or ascending colon. Sepsis is not common and acute renal failure secondary to rhabdomyolysis is rare. The causes of rhabdomyolysis are trauma, excessive exercise, alcohol, seizure, metabolic abnormality, and infection. Infections account for less than 5% of the reported causes of rhabdomyolysis and resulting acute renal failure. The mechanisms underlying rhabdomyolysis due to infection are direct muscle invasion, toxin production, and nonspecific effects that can occur with infections such as fever, dehydration, acidosis, and electrolyte imbalance. We report a case of sepsis and acute renal failure secondary to rhabdomyolysis associated with Salmonella infection.