Analysis of nontraumatic rhabdo myolysis during recent 2 years / 대한내과학회지

ABSTRACT

BACKGROUND: Rhabdomyolysis is a serious and potentially lethal condition that can develop from a variety of nontraumatic causes. Recently, there have been several reports about rhabdomyolysis which developed after alcohol abuse, drug intoxication, or vigorous exercise, but no report about all spectrums of nontraumatic rhadomyolyis in Korea. So we undertook this study to evaluate the clinical characteristics and course of nontraumatic rhabdomyolysis in a single medical center. METHODS: Several clinical and laboratory data were collected and analyzed in 68 patients with nontraumatic rhabdomyolyis from January 2002 to December 2003. RESULTS: The patients consisted of 58 males and 10 females with mean age of 48.0 +/- 16.3 years. The etiologic factors of nontraumatic rhabdomyolysis were as follows: 21 cases of alcohol abuse (30.9%), 13 cases of muscle ischemia (19%), 9 cases of shock (13%), 7 cases of infection, 6 cases of drug intoxication, 3 cases of seizure, 2 cases of malignant hyperthermia, 2 cases of diabetic ketoacidosis, 1 case of vigorous exercise, 1 case of CO poisoning, 1 case of hypophosphatemia, and 2 cases of unknown causes. Among the 68 patients, forty four patients (64%) developed acute renal failure and seventeen patients (25%) died of sepsis, acute respiratory distress syndrome, pulmonary edema or underlying diseases exacerbation. Among the 44 patients in acute renal failure, eighteen patients (41%) had oliguria during follow-up period. Thirteen patients of them needed dialysis and sixteen patients of them (36.4%) died. Another developed complications were hepatic dysfunction (34%), disseminated intravascular coagulation (28%), hypocalcemia (28%), acute respiratory distress syndrome (26%), pneumonia (22%), pulmonary edema (21%), hyperphosphatemia (7%) and hyperkalemia (4%). CONCLUSION: Nontraumatic rhabdomyolysis with acute renal failure is a serious and potentially lethal condition. Optimal treatment depends on early recognition and intervention. A high clinical suspicion for the occurrence of rhabdomyolysis in the nontraumatic conditions can lead to quicker recognition and better patient care.