Clinical characteristics of rhabdomyolysis in children / 中国小儿急救医学

ABSTRACT

Objective:To summarize the etiology, laboratory examinations and clinical features of rhabdomyolysis(RM)in children.Methods:The clinical data of children with RM admitted to the pediatric general ward at Third Hospital of Peking University from January 1st, 2010 to March 31st, 2021 were collected.The clinical characteristics, etiology distribution, laboratory examinations, treatments and prognosis of the children were analyzed.Results:A total of 24 children were included with 16 males and 8 females.The age ranged from 4 to 15 years old, with median age was 13years old.The etiology was exertional diseases in 14 cases(58.3%), non-exertional diseases in ten cases (41.7%, 7 cases of infection and 3 cases of other causes). The average age of exertional RM was(13.50±1.83)years, and that of non-exertional RM was(8.60±3.72)years.There was significant difference( t=3.848, P=0.002). The main clinical symptoms were muscle soreness, abnormal urine color and muscle weakness.Serum creatine kinase(CK)and serum myoglobin were significantly increased.The proportion of CK value moderate to severe increased of exercise RM children was significantly higher than that of non-exertional RM children( P=0.009). All children were treated with hydration and alkalization.Except for one case who died of critical primary disease, the other 23 children had good treatment response, and no rhabdomyolysis was found during the follow-up. Conclusion:The main causes of rhabdomyolysis in children are exercise and infection.Exertional RM is common in elder children.The increasing of CK level caused by exertional RM is more obvious.Active hydration and alkalization measures could avoid the occurrence of acute kidney injury.Most children with RM have good prognosis.