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Objective To investigate the clinical and epidemiological characteristics of crayfish associated rhabdomyolysis syndrome in Baiyun District, Guangzhou, and explore the related factors, and to provide evidence for the prevention of crayfish rhabdomyolysis syndrome. Methods The cases of crawfish associated rhabdomyolysis syndrome were found through the foodborne disease surveillance and reporting system, and a field epidemiological investigation was carried out to analyze the clinical and epidemiological characteristics of the cases. Results A total of 25 cases of crayfish associated rhabdomyolysis syndrome occurred in 2020. The intake of crayfish of the cases ranged from 5 to 25, the incubation period was 1 to 9.5h, and the interval from onset to medical treatment was 0.17 to 9h. All the cases had muscle pain, and the content of creatine kinase (CK) in the cases increased to varying degrees (128-17851 U/L). Retrospective cohort analysis of 10 crayfish events found no correlation between the consumption of different parts of crayfish and the incidence of crayfish-related rhabdomyolysis syndrome. Conclusion The incidence of rhabdomyolysis syndrome reported in Baiyun District of Guangzhou is related to the consumption of crayfish, but the pathogenic factors need to be further studied. It is suggested to strengthen the supervision of crayfish breeding, transportation, sales, and processing to ensure the health of consumers.
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Objective To investigate the efficacy of plasma exchange therapy in the treatment of rhabdomyolysis syndrome (RMS) caused by wasp stings. Methods Sixty patients with RMS caused by wasp stings were enrolled in the Poisoning Treatment Ward of the Affiliated Hospital of Southwest Medical University from January 2015 to June 2019, including 40 patients complicated with acute kidney injury (AKI). After admission, the patients were given local treatment and systemic medication (intravenous infusion of glucocorticoid, calcium gluconate injection, intramuscular injection of isopropazine hydrochloride and other antihistamines). Plasma exchange was performed on the first and second day after admission, and according to the renal function situations, the patients with AKI underwent intermittent hemodialysis. The changes of urea (Ur), creatinine (Cr), hypersensitive troponin T (hs-TnT), myoglobin (MYO), creatine kinase isoenzyme (CK-MB), lactic dehydrogenase (LDH) and pathological changes of kidney were monitored on admission and after twice of plasma exchanges, and the above results of indexes were compared and analyzed. Results With the prolongation of the plasma exchange time, after the first plasma exchange the level of hs-TnT was significantly higher than that before the plasma exchange [μg/L: 1.30 (0.16, 4.37) vs. 0.26 (0.06, 1.26)], and the levels of LDH and CK-MB were lower than those before the exchange [LDH (μmol·s-1·L-1): 14.01 (6.73, 31.52) vs. 20.55 (8.73, 42.46), CK-MB (U/L): 41.25 (21.27, 102.83) vs. 89.92 (35.85, 163.53), both P < 0.05]; after the second plasma exchange, the Ur, Cr, LDH, hs-TnT, MYO and CK-MB were decreased significantly compared with those before the exchange [Ur (mmol/L): 9.77 (6.43, 11.90) vs. 11.58 (7.65, 19.49), Cr (μmol/L): 90.35 (67.10, 336.10) vs. 115.25 (77.50, 288.83), LDH (μmol·s-1·L-1): 7.84 (5.14, 18.68) vs 20.55 (8.73, 42.46), hs-TnT (μg/L): 0.02 (0.01, 0.09) vs. 0.26 (0.06, 1.26), MYO (μg/L): 200.00 (70.39, 1 000.00) vs. >1 000.00 (1 000.00, >1 000.00), CK-MB (U/L): 4.34 (1.86, 23.65) vs. 89.92 (35.85, 163.56), all P < 0.05]. Under light microscope, renal tubular epithelial cells fell off and showed"naked membrane", and infiltration of a small amount of inflammatory cells could be seen. Conclusion Plasma exchange can effectively remove macromolecules such as MYO, hs-TnT, CK-MB and LDH, reduce acute renal damage caused by rhabdomyolysis syndrome, shorten the course of disease and decrease mortality.
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Neste trabalho, é descrito um caso de icterícia de íris em equino da raça Paint. Ao exame clínico, foram observados tremores, dor muscular, relutância em andar, taquicardia, taquipnéia e icterícia de íris. As concentrações séricas de creatina cinase, aspartato aminotransferase, lactato desidrogenase e bilirrubina indireta estavam marcadamente elevadas. Com base na anamnese, sintomatologia clínica e bioquimica sérica, diagnosticou-se síndrome da rabdomiólise por esforço. Foram instituídos os seguintes tratamentos: terapia analgésica, fluidoterapia e restrição de exercício. Após seis dias, houve a remissão dos sinais clínicos e o retorno da coloração original da íris.
One case of icterus iris diagnosed in an American Paint Horse is described. Stiffness, painful muscle, reluctance to move, elevated respiratory and heart rates, and icterus iris were observed in the clinical examination. Creatine kinase, aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase, and bilirubin levels were markedly elevated. Exertional rhabdomyolysis syndrome was diagnosed. Analgesic therapy, fluid therapy, and limited exercise were prescribed. After six days there was a remission of clinical signs and return the original color of the iris.