Subject(s)
Autoimmune Diseases/immunology , Brain Stem/pathology , Encephalitis/diagnosis , Encephalitis/immunology , Adult , Ataxia/immunology , Autoantibodies/immunology , Autoantigens/immunology , Autoimmune Diseases/complications , Autoimmune Diseases/diagnosis , Brain Stem/immunology , Cognitive Dysfunction/immunology , Diplopia/immunology , Encephalitis/complications , Female , Gangliosides/immunology , HumansABSTRACT
The contribution of rhabdomyolysis to acute kidney injury (AKI) in the context of burn injury is poorly studied. We sought to determine the impact of rhabdomyolysis on AKI (defined by the AKI Network classification), renal replacement therapy (RRT), and death. Patients admitted to the burn unit at our institution were examined. Information on sex, age, presence of inhalation injury, electrical burn, percentage TBSA burned, percentage of full-thickness burns, Injury Severity Score, and peak creatine kinase (CK) were recorded. These variables were examined via multivariate logistic regression analysis against AKI Network stage, RRT, and death. Of 1973 consecutive admissions meeting the inclusion criteria, 525 met our eligibility criteria. Log peak CK was found to be correlated with any stage of AKI (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.36-2.16; P < .0001), moderate to severe AKI (OR, 2.09; 95% CI, 1.40-3.11; P = .0003), need for RRT (OR, 1.67; 95% CI, 1.16-2.40; P = .0057), and mortality (OR, 1.49; 95% CI, 1.01-2.20; P = .0441), after adjustment. Each 10-fold increase in peak CK was associated with a 70% increase in the odds of AKI, more than a 100% increase in the odds of moderate to severe AKI, a nearly 70% increase in the odds of RRT, and an almost 50% increase in the odds of mortality in patients with burn injury.
Subject(s)
Acute Kidney Injury/etiology , Burns/complications , Rhabdomyolysis/complications , Adult , Chi-Square Distribution , Creatine Kinase/blood , Female , Glomerular Filtration Rate , Humans , Injury Severity Score , Logistic Models , Male , Retrospective Studies , Statistics, NonparametricABSTRACT
This is a case report of a female presenting originally with clinical picture of acute coronary syndrome and depressed left ventricular function with no angiographic evidence of coronary artery disease with mid cavitary akinesis and basal as well as apical hyperkinesis after emotional stresses identified by multi-imaging modalities to be mid cavitary Takotsubo. The Incidence and the prevalence of apical ballooning syndrome (Takotsubo) is on the rise with more reports in the literature; however, mid cavitary Takotsubo remains rare and raises questions more than answers as to the reason behind the mid cavitary localization in some patients versus apical involvement.
