Rhabdomyolysis Associated with Electric Bath: A Case Report and Review of the Literature / 日本温泉気候物理医学会雑誌

ABSTRACT

  A 53-year-old Japanese man living in Thailand who was diagnosed with prostate cancer was scheduled for a prostate biopsy due to increased serum PSA. Two days prior to his admission, he returned to Japan. The next day he was taken for pre-operative screening and blood tests, which revealed extremely high serum creatine kinase (CK) levels (13,631 IU/L). The following day, his serum CK increased to 29,836 IU/L with 100% type MM isozyme. In addition, his serum myoglobin was 3,289.0 ng/mL and his urinary myoglobin was 26,000 ng/mL. Based on these test results, the patient was diagnosed with rhabdomyolysis.  The patient revealed that he had gone to a public bath and bathed in an “electric bath” for a total of 90 min over the previous 2 days. During hospitalization, he remained asymptomatic and had no renal dysfunction. The prostate biopsy was performed as scheduled and he was given post-procedure care, including intravenous administration of saline. The patient’s serum CK peaked at 42,355 IU/L on the second day of hospitalization, and on the fifth day it decreased to 5,979 IU/L and he was discharged without any complications.   After a retrospective review of literature, only three reports were found mentioning an “electric bath”. Two of these reports were related to asymptomatic hyper-CK-emia caused by the electric bath, and one was a case related to the malfunction of an implantable cardioverter defibrillator due to an electric bath. The former two reports concluded that increased time in the electric bath was related to the observed increase in CK level. Since extended bathing in electric baths may cause rhabdomyolysis, further investigation is required to determine what duration of use is safe.