201
|
Nara A, Yajima D, Nagasawa S, Abe H, Hoshioka Y, Iwase H. Evaluations of lipid peroxidation and inflammation in short-term glycerol-induced acute kidney injury in rats. Clin Exp Pharmacol Physiol 2016; 43:1080-1086. [DOI: 10.1111/1440-1681.12633] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/07/2016] [Accepted: 08/12/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Akina Nara
- Department of Legal Medicine; Graduate School of Medicine; Chiba University; Chiba Japan
- Department of Forensic Medicine; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - Daisuke Yajima
- Department of Legal Medicine; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Sayaka Nagasawa
- Department of Legal Medicine; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Hiroko Abe
- Department of Legal Medicine; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Yumi Hoshioka
- Department of Legal Medicine; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Hirotaro Iwase
- Department of Legal Medicine; Graduate School of Medicine; Chiba University; Chiba Japan
- Department of Forensic Medicine; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| |
Collapse
|
202
|
|
203
|
Aalborg C, Rød-Larsen C, Leiro I, Aasebø W. An increase in the number of admitted patients with exercise-induced rhabdomyolysis. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2016; 136:1532-1536. [PMID: 27731596 DOI: 10.4045/tidsskr.15.1207] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Rhabdomyolysis may lead to serious complications, and treatment is both time-consuming and costly. The condition can be caused by many factors, including intense exercise. The purpose of this study was to investigate whether the number of hospitalisations due to exercise-induced rhabdomyolysis has changed in recent years. We describe the disease course in hospitalised patients, and compare disease course in individuals with exercise-induced rhabdomyolysis and rhabdomyolysis due to other causes. MATERIAL AND METHOD The study is a systematic review of medical records from Akershus University Hospital for the years 2008 and 2011 – 14. All hospitalised patients with diagnostic codes M62.8, M62.9 and T79.6 and creatine kinase levels > 5 000 IU/l were included. The cause of the rhabdomyolysis was recorded in addition to patient characteristics and the results of various laboratory tests. RESULTS Of 161 patients who were hospitalised with rhabdomyolysis during the study period, 44 cases (27 %) were classified as exercise-induced. In 2008 there were no admissions due to exercise-induced rhabdomyolysis; in 2011 and 2012 there were six and four admissions respectively, while in 2014 there were 22. This gives an estimated incidence of 0.8/100 000 in 2012 and 4.6/100 000 in 2014. Strength-training was the cause of hospitalisation in 35 patients (80 % of the exercise-induced cases). Three patients (7 % of the exercise-induced cases) had transient stage 1 kidney injury, but there were no cases with stage 2 or stage 3 injury. By comparison, 52 % of patients with rhabdomyolysis due to another cause had kidney injury, of which 28 % was stage 2 or 3. INTERPRETATION The number of persons hospitalised with exercise-induced rhabdomyolysis has increased four-fold from 2011 to 2014, possibly due to changes in exercise habits in the population. None of the patients with exercise-induced rhabdomyolysis had serological signs of kidney injury upon hospital discharge.
Collapse
Affiliation(s)
- Christian Aalborg
- Medisinsk overvåkning Medisinsk divisjon Akershus universitetssykehus
| | | | | | - Willy Aasebø
- Nyremedisinsk avdeling Medisinsk divisjon Akershus universitetssykehus
| |
Collapse
|
204
|
Galeiras R, Mourelo M, Pértega S, Lista A, Ferreiro ME, Salvador S, Montoto A, Rodríguez A. Rhabdomyolysis and acute kidney injury in patients with traumatic spinal cord injury. Indian J Crit Care Med 2016; 20:504-12. [PMID: 27688625 PMCID: PMC5027742 DOI: 10.4103/0972-5229.190370] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Patients with acute traumatic spinal cord injuries (SCIs) exhibit factors that, in other populations, have been associated with rhabdomyolysis. Purpose: The aim of the study is to determine the incidence of rhabdomyolysis in patients with acute traumatic SCI admitted to the Intensive Care Unit (ICU), as well as the development of secondary acute kidney injury and associated factors. Study Design and Setting: This was an observational, retrospective study. Patient Sample: All adult patients admitted to the ICU with acute traumatic SCI who presented rhabdomyolysis, diagnosed through creatine phosphokinase (CPK) levels >500 IU/L. Outcome Measures: Incidence of rhabdomyolysis and subsequent renal dysfunction was calculated. Materials and Methods: Data about demographic variables, comorbidity, rhabdomyolysis risk factors, and variables involving SCI, severity scores, and laboratory parameters were obtained from clinical records. Multivariate logistic regression was used to identify renal injury risk factors. Results: In 2006–2014, 200 patients with acute SCI were admitted to ICU. Of these, 103 had rhabdomyolysis (incidence = 51.5%; 95% confidence interval [CI]: 44.3%–58.7%). The most typical American Spinal Injury Association classification was A (70.3%). The injury severity score was 30.3 ± 12.1 and sequential organ failure assessment (SOFA) score was 5.6 ± 3.3 points. During their stay, 57 patients (55.3%; 95% CI: 45.2%–65.4%) presented renal dysfunction (creatinine ≥1.2 mg/dL). In the multivariate analysis, variables associated with renal dysfunction were creatinine at admission (odds ratio [OR] = 9.20; P = 0.006) and hemodynamic SOFA score the day following admission (OR = 1.33; P = 0.024). Creatinine was a better predictor of renal dysfunction than the peak CPK value during the rhabdomyolysis (area under the receiver operating characteristic curve: 0.91 vs. 0.63, respectively). Conclusions: Rhabdomyolysis is a frequent condition in patients with acute traumatic SCI admitted to the ICU, and renal dysfunction occurs in half of the cases. Creatinine values should be requested starting at the admission while neither the peak CPK values nor the hemodynamic SOFA scores could be used to properly discriminate between patients with and without renal dysfunction.
Collapse
Affiliation(s)
- Rita Galeiras
- Critical Care Unit, Complexo Hospitalario Universitario de A Coruña, University of A Coruña, CP: 15006 A Coruña, Spain
| | - Mónica Mourelo
- Critical Care Unit, Complexo Hospitalario Universitario de A Coruña, University of A Coruña, CP: 15006 A Coruña, Spain
| | - Sonia Pértega
- Clinical Epidemiology and Biostatistics Unit, Complexo Hospitalario Universitario de A Coruña, University of A Coruña, CP: 15006 A Coruña, Spain
| | - Amanda Lista
- Critical Care Unit, Complexo Hospitalario Universitario de A Coruña, University of A Coruña, CP: 15006 A Coruña, Spain
| | - M Elena Ferreiro
- Spinal Cord Injury Unit, Complexo Hospitalario Universitario de A Coruña, University of A Coruña. CP: 15006 A Coruña, Spain
| | - Sebastián Salvador
- Spinal Cord Injury Unit, Complexo Hospitalario Universitario de A Coruña, University of A Coruña. CP: 15006 A Coruña, Spain
| | - Antonio Montoto
- Spinal Cord Injury Unit, Complexo Hospitalario Universitario de A Coruña, University of A Coruña. CP: 15006 A Coruña, Spain
| | - Antonio Rodríguez
- Spinal Cord Injury Unit, Complexo Hospitalario Universitario de A Coruña, University of A Coruña. CP: 15006 A Coruña, Spain
| |
Collapse
|
205
|
Mécanismes et prise en charge de la tubulopathie liée à la rhabdomyolyse. MEDECINE INTENSIVE REANIMATION 2016. [DOI: 10.1007/s13546-016-1229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
206
|
Voermans NC, Snoeck M, Jungbluth H. RYR1-related rhabdomyolysis: A common but probably underdiagnosed manifestation of skeletal muscle ryanodine receptor dysfunction. Rev Neurol (Paris) 2016; 172:546-558. [PMID: 27663056 DOI: 10.1016/j.neurol.2016.07.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 07/29/2016] [Indexed: 01/04/2023]
Abstract
Mutations in the skeletal muscle ryanodine receptor (RYR1) gene are associated with a wide spectrum of inherited myopathies presenting throughout life. Malignant hyperthermia susceptibility (MHS)-related RYR1 mutations have emerged as a common cause of exertional rhabdomyolysis, accounting for up to 30% of rhabdomyolysis episodes in otherwise healthy individuals. Common triggers are exercise and heat and, less frequently, viral infections, alcohol and drugs. Most subjects are normally strong and have no personal or family history of malignant hyperthermia. Heat intolerance and cold-induced muscle stiffness may be a feature. Recognition of this (probably not uncommon) rhabdomyolysis cause is vital for effective counselling, to identify potentially malignant hyperthermia-susceptible individuals and to adapt training regimes. Studies in various animal models provide insights regarding possible pathophysiological mechanisms and offer therapeutic perspectives.
Collapse
Affiliation(s)
- N C Voermans
- Department of Neurology, Radboud University Medical Centre, R. Postlaan 4 (route 935), P.O. Box 9101, 6500 Nijmegen (935), The Netherlands.
| | - M Snoeck
- Department of Anaesthesia, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - H Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Randall Division of Cell and Molecular Biophysics, Muscle Signalling Section, London, UK; Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| |
Collapse
|
207
|
Kim YH, Ham YR, Na KR, Lee KW, Choi DE. Spinning: an arising cause of rhabdomyolysis in young females. Intern Med J 2016; 46:1062-8. [DOI: 10.1111/imj.13168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/23/2016] [Accepted: 06/12/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Y. H. Kim
- Internal Medicine, College of Medicine; Chungnam National University; Daejeon Korea
| | - Y. R. Ham
- Internal Medicine, College of Medicine; Chungnam National University; Daejeon Korea
| | - K. R. Na
- Internal Medicine, College of Medicine; Chungnam National University; Daejeon Korea
| | - K. W. Lee
- Internal Medicine, College of Medicine; Chungnam National University; Daejeon Korea
| | - D. E. Choi
- Internal Medicine, College of Medicine; Chungnam National University; Daejeon Korea
| |
Collapse
|
208
|
Scalco RS, Snoeck M, Quinlivan R, Treves S, Laforét P, Jungbluth H, Voermans NC. Exertional rhabdomyolysis: physiological response or manifestation of an underlying myopathy? BMJ Open Sport Exerc Med 2016; 2:e000151. [PMID: 27900193 PMCID: PMC5117086 DOI: 10.1136/bmjsem-2016-000151] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 12/14/2022] Open
Abstract
Exertional rhabdomyolysis is characterised by muscle breakdown associated with strenuous exercise or normal exercise under extreme circumstances. Key features are severe muscle pain and sudden transient elevation of serum creatine kinase (CK) levels with or without associated myoglobinuria. Mild cases may remain unnoticed or undiagnosed. Exertional rhabdomyolysis is well described among athletes and military personnel, but may occur in anybody exposed to unaccustomed exercise. In contrast, exertional rhabdomyolysis may be the first manifestation of a genetic muscle disease that lowers the exercise threshold for developing muscle breakdown. Repeated episodes of exertional rhabdomyolysis should raise the suspicion of such an underlying disorder, in particular in individuals in whom the severity of the rhabdomyolysis episodes exceeds the expected response to the exercise performed. The present review aims to provide a practical guideline for the acute management and postepisode counselling of patients with exertional rhabdomyolysis, with a particular emphasis on when to suspect an underlying genetic disorder. The pathophysiology and its clinical features are reviewed, emphasising four main stepwise approaches: (1) the clinical significance of an acute episode, (2) risks of renal impairment, (3) clinical indicators of an underlying genetic disorders and (4) when and how to recommence sport activity following an acute episode of rhabdomyolysis. Genetic backgrounds that appear to be associated with both enhanced athletic performance and increased rhabdomyolysis risk are briefly reviewed.
Collapse
Affiliation(s)
- Renata S Scalco
- MRC Centre for Neuromuscular Diseases , Institute of Neurology, University College London , London , UK
| | - Marc Snoeck
- MH-investigation Unit, Department of Anesthesia , Canisius-Wilhelmina Hospital , Nijmegen , The Netherlands
| | - Ros Quinlivan
- MRC Centre for Neuromuscular Diseases , Institute of Neurology, University College London , London , UK
| | - Susan Treves
- Departments of Anesthesia and of Biomedicine, Basel University Hospital, Basel, Switzerland; Department of Life Sciences, General Pathology Section, University of Ferrara, Ferrara, Italy
| | - Pascal Laforét
- Institut de Myologie, Hôpital Pitié-Salpêtrière , Paris , France
| | - Heinz Jungbluth
- Department of Paediatric Neurology-Neuromuscular Service, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK; Randall Division of Cell and Molecular Biophysics, Muscle Signalling Section, London, UK; Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Nicol C Voermans
- Department of Neurology , Radboud University Medical Centre , Nijmegen , The Netherlands
| |
Collapse
|
209
|
El Ters M, Patel SM, Norby SM. Hypothyroidism and reversible kidney dysfunction: an essential relationship to recognize. Endocr Pract 2016; 20:490-9. [PMID: 24325990 DOI: 10.4158/ep12084.ra] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To report 3 cases of reversible hypothyroidism-induced kidney dysfunction and review the interaction between these commonly encountered, yet seemingly disparate, conditions. METHODS We describe the clinical course and laboratory and physical findings of 3 patients who presented with kidney dysfunction that improved after initiating thyroid hormone replacement therapy. We also review similar cases in the literature and discuss the pathophysiologic mechanisms. RESULTS A 68-year-old male presented with classical signs and symptoms of hypothyroidism, including fatigue, confusion, and gait imbalance. Physical exam showed bradycardia, thyromegaly, slow mentation, and cracked, thin skin; he was found to have decreased kidney function. Second, a 42-year-old previously healthy female presented with bilateral hand swelling and elevated serum creatinine with an otherwise unremarkable physical exam. The third patient was a 72-year-old male with advanced heart failure on amiodarone and stage 3 chronic kidney disease who presented with fatigue, acute kidney injury, and lower extremity edema. In all cases, serum creatinine and thyroid-stimulating hormone (TSH) were elevated at presentation (1.4-3.0 mg/dL and 94.1-184 mIU/L respectively), and free thyroxine (T4) was low (undetectable-0.4 ng/dL). The initiation or increased dose of levothyroxine normalized serum creatinine to baseline within 2 to 10 months. CONCLUSION Hypothyroidism and kidney dysfunction are both commonly encountered clinical entities, but the interplay between the thyroid gland and kidneys may be infrequently recalled, causing the reversible relationship between these 2 disorders to be missed.
Collapse
Affiliation(s)
- Mireille El Ters
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Sandeep M Patel
- The Heart and Vascular Institute, University of Pittsburgh, Pennsylvania
| | - Suzanne M Norby
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
210
|
Ely MR, Romero SA, Sieck DC, Mangum JE, Luttrell MJ, Halliwill JR. A single dose of histamine-receptor antagonists before downhill running alters markers of muscle damage and delayed-onset muscle soreness. J Appl Physiol (1985) 2016; 122:631-641. [PMID: 27493198 DOI: 10.1152/japplphysiol.00518.2016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/13/2016] [Accepted: 07/28/2016] [Indexed: 11/22/2022] Open
Abstract
Histamine contributes to elevations in skeletal muscle blood flow following exercise, which raises the possibility that histamine is an important mediator of the inflammatory response to exercise. We examined the influence of antihistamines on postexercise blood flow, inflammation, muscle damage, and delayed-onset muscle soreness (DOMS) in a model of moderate exercise-induced muscle damage. Subjects consumed either a combination of fexofenadine and ranitidine (blockade, n = 12) or nothing (control, n = 12) before 45 min of downhill running (-10% grade). Blood flow to the leg was measured before and throughout 120 min of exercise recovery. Markers of inflammation, muscle damage, and DOMS were obtained before and at 0, 6, 12, 24, 48, and 72 h postexercise. At 60 min postexercise, blood flow was reduced ~29% with blockade compared with control (P < 0.05). Markers of inflammation were elevated after exercise (TNF-ɑ, IL-6), but did not differ between control and blockade. Creatine kinase concentrations peaked 12 h after exercise, and the overall response was greater with blockade (18.3 ± 3.2 kU·l-1·h-1) compared with control (11.6 ± 2.0 kU·l-1·h-1; P < 0.05). Reductions in muscle strength in control (-19.3 ± 4.3% at 24 h) were greater than blockade (-7.8 ± 4.8%; P < 0.05) and corresponded with greater perceptions of pain/discomfort in control compared with blockade. In conclusion, histamine-receptor blockade reduced postexercise blood flow, had no effect on the pattern of inflammatory markers, increased serum creatine kinase concentrations, attenuated muscle strength loss, and reduced pain perception following muscle-damaging exercise.NEW & NOTEWORTHY Histamine appears to be intimately involved with skeletal muscle during and following exercise. Blocking histamine's actions during muscle-damaging exercise, via common over-the-counter antihistamines, resulted in increased serum creatine kinase, an indirect marker of muscle damage. Paradoxically, blocking histamine's actions attenuated muscle strength loss and reduced perceptions of muscle pain for 72 h following muscle-damaging exercise. These results indicate that exercise-induced histamine release may have a broad impact on protecting muscle from exercise-induced damage.
Collapse
Affiliation(s)
- Matthew R Ely
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Steven A Romero
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Dylan C Sieck
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | - Joshua E Mangum
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| | | | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, Oregon
| |
Collapse
|
211
|
|
212
|
Cunningham J, Sharma R, Kirzner A, Hwang S, Lefkowitz R, Greenspan D, Shapoval A, Panicek DM. Acute myonecrosis on MRI: etiologies in an oncological cohort and assessment of interobserver variability. Skeletal Radiol 2016; 45:1069-78. [PMID: 27105618 PMCID: PMC4912434 DOI: 10.1007/s00256-016-2389-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/27/2016] [Accepted: 04/06/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the etiologies of myonecrosis in oncology patients and to assess interobserver variability in interpreting its MRI features. MATERIALS AND METHODS Pathology records in our tertiary cancer hospital were searched for proven myonecrosis, and MRIs of affected regions in those patients were identified. MRI reports that suggested myonecrosis were also identified. Each MRI was reviewed independently by 2 out of 6 readers to assess anatomical site, size, and signal intensities of muscle changes, and the presence of the previously reported stipple sign (enhancing foci within a region defined by rim enhancement). The stipple sign was assessed again, weeks after a training session. Cohen kappa and percentage agreement were calculated. Medical records were reviewed for contemporaneous causes of myonecrosis. RESULTS MRI reports in 73 patients suggested the diagnosis of myonecrosis; pathological proof was available in another 2. Myonecrosis was frequently associated with radiotherapy (n = 34 patients, 45 %); less frequent causes included intraoperative immobilization, trauma, therapeutic embolization, ablation therapy, exercise, and diabetes. Myonecrosis usually involved the lower extremity, the pelvis, and the upper extremity; mean size was 13.0 cm. The stipple sign was observed in 55-100 % of patients at first assessment (κ = 0.09-0.42; 60-80 % agreement) and 55-100 % at second (κ = 0.0-0.58; 72-90 % agreement). Enhancement surrounded myonecrosis in 55-100 % patients (κ = 0.03-0.32; 58-70 % agreement). CONCLUSION Myonecrosis in oncology patients usually occurred after radiotherapy, and less commonly after intraoperative immobilization, trauma, therapeutic embolization, ablation therapy, exercise, or diabetes. Although interobserver variability for MRI features of myonecrosis exists (even after focused training), a combination of findings facilitates diagnosis and conservative management.
Collapse
Affiliation(s)
- Jane Cunningham
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY 10065
| | - Richa Sharma
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY 10065
| | - Anna Kirzner
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY 10065
| | - Sinchun Hwang
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY 10065,Weill Medical College of Cornell University, New York, NY 10065
| | - Robert Lefkowitz
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY 10065,Weill Medical College of Cornell University, New York, NY 10065
| | - Daniel Greenspan
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY 10065
| | - Anton Shapoval
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY 10065
| | - David M. Panicek
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue, New York, NY 10065,Weill Medical College of Cornell University, New York, NY 10065
| |
Collapse
|
213
|
Jo YI, Song JO, Park JH, Koh SY, Lee SM, Seo TH, Lee JH. Risk factors for rhabdomyolysis following doxylamine overdose. Hum Exp Toxicol 2016; 26:617-21. [PMID: 17884948 DOI: 10.1177/0960327107077507] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this prospective study was to identify risk factors for developing rhabdomyolysis in patients with doxylamine overdose. Patients who were admitted to a university teaching hospital between July 2000 and September 2005 due to doxylamine overdose were recruited. Demographic information, clinical variables, and laboratory data were investigated. Twenty-seven (M/F 12/15, age 33.2 ±13.1 years) patients were enrolled. Sixteen (59%) of 27 patients developed rhabdomyolysis and three (19%) of 16 patients with rhabdomyolysis also developed acute renal failure. Patients who developed rhabdomyolysis differed from those who did not in the amount of doxylamine ingested, initial serum creatitnine and arterial pH. In multivariate regression analysis, the only reliable predictor of rhabdomyolysis was the amount of doxylamine ingested ( P = 0.039). The amount of doxylamine ingested (≥ 20 mg/kg) predicted the development of rhabdomyolysis with a sensitivity of 81%, a specificity of 82%, a positive predictive value of 87%, and a negative predictive value of 75%. In conclusion, rhabdomyolysis following doxylamine overdose was common, occurring in 87% of patients who ingested more than 20 mg/kg. The amount of doxylamine ingested was the only reliable predictor for developing rhabdomyolysis following doxylamine overdose. Human & Experimental Toxicology (2007) 26, 617—621
Collapse
Affiliation(s)
- Young-Il Jo
- Division of Nephrology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | | | | | | | | | | | | |
Collapse
|
214
|
Talaie H, Pajouhmand A, Abdollahi M, Panahandeh R, Emami H, Hajinasrolah S, Tghaddosinezhad M. Rhabdomyolysis among acute human poisoning cases. Hum Exp Toxicol 2016; 26:557-61. [PMID: 17884958 DOI: 10.1177/0960327107078667] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Rhabdomyolysis is a clinical and biochemical syndrome occurring when skeletal muscle cells erupt and result in release of creatine phosphokinase (CPK), lactate dehydrogenase (LDH) and myoglobin into the interstitial space and plasma. Mechanical trauma, compression, excessive muscle activity and ischemia are frequent causes, but non-traumatic rhabdomyolysis is usually caused by a toxic reaction to drugs.In this study, 181 patients suspected of rhabdomyolysis were admitted to the poisoning center of Loghman-Hakim Hospital in Tehran during one year (September 2004 to September 2005) were studied. Patients were included on the basis of physical examination and blood analysis for CPK and LDH. Rhabdomyolysis was confirmed if CPK level has been greater than 975 U/L. Out of 181 patients, 64 were female and 117 were male with an age range between 13—78 years. One-hundred and forty-three (79%) patients had CPK greater than 975 U/L. In 6% of the cases, multiple drug poisoning were observed. Two patients (1.1%) had muscle pain, five patients (2.8%) had rigidity and five patients (2.8%) had muscle inflammation. One-hundred and nineteen patients (65.7%) were febrile. The most common cause of rhabdomyolysis was opium. Blood ALT showed an increase in 109 patients (60.9%), AST in 80 patients (44.7%), and LDH in 144 patients (79.6%). Fifty patients (28.2%) had higher blood direct bilirubin and 64 patients (36.4%) showed higher total bilirubin. Six percent of patients had been diagnosed as ARF by indication of creatinine greater than 1.4 mg/dL. Five percent of patients had hypernatremia and 1.1% of patients had hyperkalemia.It is concluded that rhabdomyolysis is a matter of concern in human poisonings and needs special approach to attend. Human & Experimental Toxicology (2007) 26: 557—561.
Collapse
Affiliation(s)
- H Talaie
- Toxicological Research Center, Loghman-Hakim Hospital, School of Medicine, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | |
Collapse
|
215
|
Sahutoglu T, Atay K, Caliskan Y, Kara E, Yazici H, Turkmen A. Comparative Analysis of Outcomes of Kidney Transplantation in Patients With AA Amyloidosis and Chronic Glomerulonephritis. Transplant Proc 2016; 48:2011-6. [DOI: 10.1016/j.transproceed.2016.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/07/2016] [Accepted: 04/27/2016] [Indexed: 01/24/2023]
|
216
|
|
217
|
Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical practice. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:135. [PMID: 27301374 PMCID: PMC4908773 DOI: 10.1186/s13054-016-1314-5] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Rhabdomyolysis is a clinical syndrome that comprises destruction of skeletal muscle with outflow of intracellular muscle content into the bloodstream. There is a great heterogeneity in the literature regarding definition, epidemiology, and treatment. The aim of this systematic literature review was to summarize the current state of knowledge regarding the epidemiologic data, definition, and management of rhabdomyolysis. Methods A systematic search was conducted using the keywords “rhabdomyolysis” and “crush syndrome” covering all articles from January 2006 to December 2015 in three databases (MEDLINE, SCOPUS, and ScienceDirect). The search was divided into two steps: first, all articles that included data regarding definition, pathophysiology, and diagnosis were identified, excluding only case reports; then articles of original research with humans that reported epidemiological data (e.g., risk factors, common etiologies, and mortality) or treatment of rhabdomyolysis were identified. Information was summarized and organized based on these topics. Results The search generated 5632 articles. After screening titles and abstracts, 164 articles were retrieved and read: 56 articles met the final inclusion criteria; 23 were reviews (narrative or systematic); 16 were original articles containing epidemiological data; and six contained treatment specifications for patients with rhabdomyolysis. Conclusion Most studies defined rhabdomyolysis based on creatine kinase values five times above the upper limit of normal. Etiologies differ among the adult and pediatric populations and no randomized controlled trials have been done to compare intravenous fluid therapy alone versus intravenous fluid therapy with bicarbonate and/or mannitol.
Collapse
|
218
|
Dubin I, Gelber M, Schattner A. Rare times rare: The hyponatremia, rhabdomyolysis, anterior compartment syndrome sequence. JRSM Open 2016; 7:2054270416629326. [PMID: 27186379 PMCID: PMC4858724 DOI: 10.1177/2054270416629326] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Primary polydipsia occurs in up to 25% of patients with chronic psychiatric disorders (especially schizophrenia), related to the disease, its treatment or both. Urine output fails to match intake >10 L/day and water intoxication may develop. Rhabdomyolysis is a rare complication of hyponatremia, and an acute anterior compartment syndrome of the leg, an emergency, may be very rarely associated.
Collapse
Affiliation(s)
- Ina Dubin
- Department of Medicine, Laniado Hospital, Sanz Medical Center, Netanya
| | - Moshe Gelber
- Department of Medicine, Laniado Hospital, Sanz Medical Center, Netanya
| | - Ami Schattner
- Department of Medicine, Laniado Hospital, Sanz Medical Center, Netanya; Faculty of Medicine, Hebrew University and Hadassah Medical School, Jerusalem, Israel
| |
Collapse
|
219
|
Suzuki Y, Kawashima Y. Intrahepatic and extrahepatic aminotransferase elevation associated with clinical‐therapeutic events in a schizophrenic patient. Clin Case Rep 2016; 4:469-72. [PMID: 27190609 PMCID: PMC4856238 DOI: 10.1002/ccr3.546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 11/26/2015] [Accepted: 03/03/2016] [Indexed: 01/04/2023] Open
Abstract
A schizophrenic patient showed rhabdomyolysis with idiopathic transaminitis. The intermixed pattern of intrahepatic and extrahepatic alanine aminotransferase (ALT) elevation is associated with respective clinical‐therapeutic events. Aminotransferases play a role as surrogate biomarkers of “liver metabolic functioning” beyond the obsolete classical concept associating ALT elevation only with liver cellular damage.
Collapse
|
220
|
Rubio-Navarro A, Carril M, Padro D, Guerrero-Hue M, Tarín C, Samaniego R, Cannata P, Cano A, Villalobos JMA, Sevillano ÁM, Yuste C, Gutiérrez E, Praga M, Egido J, Moreno JA. CD163-Macrophages Are Involved in Rhabdomyolysis-Induced Kidney Injury and May Be Detected by MRI with Targeted Gold-Coated Iron Oxide Nanoparticles. Theranostics 2016; 6:896-914. [PMID: 27162559 PMCID: PMC4860897 DOI: 10.7150/thno.14915] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/18/2016] [Indexed: 02/07/2023] Open
Abstract
Macrophages play an important role in rhabdomyolysis-acute kidney injury (AKI), although the molecular mechanisms involved in macrophage differentiation are poorly understood. We analyzed the expression and regulation of CD163, a membrane receptor mainly expressed by anti-inflammatory M2 macrophages, in rhabdomyolysis-AKI and developed targeted probes for its specific detection in vivo by MRI. Intramuscular injection of glycerol in mice promoted an early inflammatory response, with elevated proportion of M1 macrophages, and partial differentiation towards a M2 phenotype in later stages, where increased CD163 expression was observed. Immunohistological studies confirmed the presence of CD163-macrophages in human rhabdomyolysis-AKI. In cultured macrophages, myoglobin upregulated CD163 expression via HO-1/IL-10 axis. Moreover, we developed gold-coated iron oxide nanoparticles vectorized with an anti-CD163 antibody that specifically targeted CD163 in kidneys from glycerol-injected mice, as determined by MRI studies, and confirmed by electron microscopy and immunological analysis. Our findings are the first to demonstrate that CD163 is present in both human and experimental rhabdomyolysis-induced AKI, suggesting an important role of this molecule in this pathological condition. Therefore, the use of probes targeting CD163-macrophages by MRI may provide important information about the cellular composition of renal lesion in rhabdomyolysis.
Collapse
|
221
|
Jiang W, Wang X, Zhou S. Rhabdomyolysis induced by antiepileptic drugs: characteristics, treatment and prognosis. Expert Opin Drug Saf 2016; 15:357-65. [DOI: 10.1517/14740338.2016.1139572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
222
|
|
223
|
Lahoria R, Milone M. Rhabdomyolysis featuring muscular dystrophies. J Neurol Sci 2016; 361:29-33. [DOI: 10.1016/j.jns.2015.12.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/09/2015] [Accepted: 12/08/2015] [Indexed: 12/13/2022]
|
224
|
Carrillo-Esper R, Galván-Talamantes Y, Meza-Ayala CM, Cruz-Santana JA, Bonilla-Reséndiz LI. [Ultrasound findings in rhabdomyolysis]. CIR CIR 2016; 84:518-522. [PMID: 26772896 DOI: 10.1016/j.circir.2015.06.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 06/05/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Rhabdomyolysis is defined as skeletal muscle necrosis. Ultrasound assessment has recently become a useful tool for the diagnosis and monitoring of muscle diseases, including rhabdomyolysis. A case is presented on the ultrasound findings in a patient with rhabdomyolysis. OBJECTIVE To highlight the importance of ultrasound as an essential part in the diagnosis in rhabdomyolysis, to describe the ultrasound findings, and review the literature. CLINICAL CASE A 30 year-old with post-traumatic rhabdomyolysis of both thighs. Ultrasound was performed using a Philips Sparq model with a high-frequency linear transducer (5-10MHz), in low-dimensional scanning mode (2D), in longitudinal and transverse sections at the level of both thighs. The images obtained showed disorganisation of the orientation of the muscle fibres, ground glass image, thickening of the muscular fascia, and the presence of anechoic areas. CONCLUSIONS Ultrasound is a useful tool in the evaluation of rhabdomyolysis.
Collapse
Affiliation(s)
- Raúl Carrillo-Esper
- Unidad de Terapia Intensiva, Fundación Clínica Médica Sur, Tlalpan, Ciudad de México, México
| | | | | | | | | |
Collapse
|
225
|
Abstract
BACKGROUND Rhabdomyolysis is a recognized complication of traumatic injury. The correlation of an elevated creatine kinase (CK) level and the development of acute kidney injury (AKI) has been studied in the civilian population. We sought to review the prevalence of rhabdomyolysis in injured war fighters and determine if peak CK levels correlate with AKI. METHODS This is a retrospective cohort study of patients admitted at a US military treatment facility from January to November 2010. Inclusion criteria were active duty patients transported after explosive, penetrating, or blunt injury. Patients with burns or non-trauma-related admissions were excluded. Rhabdomyolysis was defined as a CK level greater than 5,000 U/L. AKI was defined using the Kidney Disease: Improving Global Outcomes classification. Mann-Whitney U-tests were used to determine the significance for continuous data. Correlations were determined using Spearman's ρ. Significance was set at p < 0.05. RESULTS Of the 318 patients included in our analysis, 310 (98%) were male, and the median age was 24 years (21-28 years). Blast was the predominant mechanism of injury (71%), with a median Injury Severity Score (ISS) of 22 (16-29). Rhabdomyolysis developed in 79 patients (24.8%). The median peak CK for all patients was 4,178 U/L and ranged from 208 U/L to 120,000 U/L. Stage 1, 2, and 3 AKI developed in 56 (17.6%), 3 (0.9%), and 7 (2.2%) patients, respectively. There was a weak but statistically significant correlation between peak CK and AKI (r = 0.26, p < 0.05). CONCLUSION Elevated peak CK levels in the injured war fighter are weakly associated with the development of AKI but are not predictive. The development of clinical practice guidelines would help standardize treatment for rhabdomyolysis in combat casualties and would allow for standardized comparisons in future work. LEVEL OF EVIDENCE Epidemiologic/prognostic study, level III.
Collapse
|
226
|
Lippi G, Plebani M. Serum myoglobin immunoassays: obsolete or still clinically useful? ACTA ACUST UNITED AC 2016; 54:1541-3. [DOI: 10.1515/cclm-2016-0472] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
227
|
Jaradat SA, Amayreh W, Al-Qa'qa' K, Krayyem J. Molecular analysis of LPIN1 in Jordanian patients with rhabdomyolysis. Meta Gene 2015; 7:90-4. [PMID: 26909335 PMCID: PMC4733219 DOI: 10.1016/j.mgene.2015.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/15/2015] [Accepted: 12/02/2015] [Indexed: 12/31/2022] Open
Abstract
Recessive mutations in LPIN1, which encodes a phosphatidate phosphatase enzyme, are a frequent cause of severe rhabdomyolysis in childhood. Hence, we sequenced the 19 coding exons of the gene in eight patients with recurrent hereditary myoglobinuria from four unrelated families in Jordan. The long-term goal is to facilitate molecular genetic diagnosis without the need for invasive procedures such as muscle biopsies. Three different mutations were detected, including the novel missense mutation c.2395G>C (Gly799Arg), which was found in two families. The two other mutations, c.2174G>A (Arg725His) and c.1162C>T (Arg388X), have been previously identified, and were found to cosegregate with the disease phenotype in the other two families. Intriguingly, patients homozygous for Arg725His were also homozygous for the c.1828C>T (Pro610Ser) polymorphism, and were exercise-intolerant between myoglobinuria episodes. Notably, patients homozygous for Arg388X were also homozygous for the c.2250G>C silent variant (Gly750Gly). Taken together, the data provide family-based evidence linking hereditary myoglobinuria to pathogenic variations in the C-terminal lipin domain of the enzyme. This finding highlights the functional significance of this domain in the absence of structural information. This is the first analysis of LPIN1 in myoglobinuria patients of Jordanian origin, and the fourth such analysis worldwide. LPIN1 mutations were cataloged in families with hereditary myoglobinuria. A novel missense Gly799Arg mutation was identified. Arg725His, the only other known missense mutation, was confirmed to be pathogenic. Arg388X, a known nonsense mutation, was the most common among Arabic patients. Patients exercise-intolerant between myoglobinuria episodes have a second mutation.
Collapse
Affiliation(s)
- Saied A Jaradat
- Princess Haya Biotechnology Center, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Wajdi Amayreh
- Department of Pediatrics, Metabolic Genetics Clinic, Queen Rania Al-Abdullah Children's Hospital, King Hussein Medical Centre, Amman 11855, Jordan
| | - Kefah Al-Qa'qa'
- Department of Pediatrics, Metabolic Genetics Clinic, Queen Rania Al-Abdullah Children's Hospital, King Hussein Medical Centre, Amman 11855, Jordan
| | - Jan Krayyem
- Princess Haya Biotechnology Center, Jordan University of Science and Technology, Irbid 22110, Jordan
| |
Collapse
|
228
|
Kim D, Ko EJ, Cho H, Park SH, Lee SH, Cho NG, Lee SY, Jeong HY, Yang DH. Spinning-induced Rhabdomyolysis: Eleven Case Reports and Review of the Literature. Electrolyte Blood Press 2015; 13:58-61. [PMID: 26848305 PMCID: PMC4737663 DOI: 10.5049/ebp.2015.13.2.58] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 10/06/2015] [Indexed: 01/01/2023] Open
Abstract
Non-traumatic exertional rhabdomyolysis (exRML) occurs in individuals with normal muscles when the energy supplied to the muscle is insufficient. Here, we report 11 cases of spinning-induced rhabdomyolysis and review related literature. Spinning is a kind of indoor bicycle sport. The 11 patients who were diagnosed with exRML and admitted to CHA Bundang Medical Center were female and their ages ranged from 15 to 46 years. Two to three days prior to the presentation, the patients had attended a spinning class for the first time. All the patients had been otherwise healthy without any known medical illnesses. They were successfully treated without any complications, except mild non-symptomatic hypocalcemia. However, in the literature, severe complications such as compartment syndrome or acute kidney injury had been reported in relation to exRML including spinning-induced rhabdomyolysis. This spinning exercise needs prior guidelines and specific warnings to prevent exertional rhabdomyolysis.
Collapse
Affiliation(s)
- Daejin Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - Eun-Jung Ko
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - HyeJeong Cho
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - Su Hyung Park
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - Sang Hwan Lee
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - Nam-gil Cho
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - So-Young Lee
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - Hye Yun Jeong
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| | - Dong Ho Yang
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Korea
| |
Collapse
|
229
|
Raurich JM, Llompart-Pou JA, Rodríguez-Yago M, Ferreruela M, Royo C, Ayestarán I. Role of Elevated Aminotransferases in ICU Patients with Rhabdomyolysis. Am Surg 2015. [DOI: 10.1177/000313481508101219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
To evaluate whether patients with rhabdomyolysis and serum alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) higher than 1000 IU/L had higher mortality that patients with low aminotransferases. Retrospective analysis of intensive care unit patients with rhabdomyolysis [creatine kinase (CK) higher than 5000 IU/L]. Patients were classified in two groups: low aminotransferases group, when AST and ALT were equal or lower to 1000 IU/L, and elevated aminotransferases group, when AST or ALT was above 1000 IU/L. Forty-six out of 189 patients included in the analysis (24.3%) had elevated aminotransferases. The mortality of patients with rhabdomyolysis was 25.9 per cent, being higher in patients with elevated aminotransferases compared with patients with low aminotransferases (60.9% vs 14.7%; P < 0.001). Mortality stratified by quartiles of CK in patients with low aminotransferases was independent of the level of CK ( P = 0.67). Logistic regression analysis showed that the independent variables associated with mortality were Simplified Acute Physiology Score II [1.11 (1.07–1.16) for each point of increase, P < 0.001], the international normalized ratio value [4.2 (1.6–10.7) for each point of increase, P = 0.003], and the need of renal replacement therapy [5.4 (1.7–17.2), P = 0.004]. Patients with rhabdomyolysis with elevated serum aminotransferases had higher mortality than patients with low serum aminotransferase levels.
Collapse
Affiliation(s)
- Joan M. Raurich
- Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain
| | - Juan A. Llompart-Pou
- Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain
| | - Miguel Rodríguez-Yago
- Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain
| | - Mireia Ferreruela
- Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain
| | - Cristina Royo
- Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain
| | - Ignacio Ayestarán
- Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, Illes Balears, Spain
| |
Collapse
|
230
|
|
231
|
Molenaar JP, Voermans NC, van Hoeve BJ, Kamsteeg EJ, Kluijtmans LA, Kusters B, Jungbluth HJ, van Engelen BG. Fever-induced recurrent rhabdomyolysis due to a novel mutation in the ryanodine receptor type 1 gene. Intern Med J 2015; 44:819-20. [PMID: 25081049 DOI: 10.1111/imj.12498] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 04/08/2014] [Indexed: 11/27/2022]
Affiliation(s)
- J P Molenaar
- Department of Neurology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | | | | | | | | | | | | | | |
Collapse
|
232
|
Rhabdomyolysis due to Trimethoprim-Sulfamethoxazole Administration following a Hematopoietic Stem Cell Transplant. Case Rep Oncol Med 2015; 2015:619473. [PMID: 26557399 PMCID: PMC4628682 DOI: 10.1155/2015/619473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 09/25/2015] [Accepted: 10/04/2015] [Indexed: 01/04/2023] Open
Abstract
Rhabdomyolysis, a syndrome of muscle necrosis, is a life-threatening event. Here we describe the case of a patient with chronic myeloid leukemia who underwent a haploidentical stem cell transplant and subsequently developed rhabdomyolysis after beginning trimethoprim-sulfamethoxazole (TMP/SMX) prophylaxis therapy. Rechallenge with TMP/SMX resulted in a repeat episode of rhabdomyolysis and confirmed the association. Withdrawal of TMP/SMX led to sustained normalization of creatine kinase levels in the patient. A high index of suspicion is necessary to identify TMP/SMX as the cause of rhabdomyolysis in immunocompromised patients.
Collapse
|
233
|
Chaudhary N, Duggal AK, Makhija P, Puri V, Khwaja GA. Statin-induced bilateral foot drop in a case of hypothyroidism. Ann Indian Acad Neurol 2015; 18:331-4. [PMID: 26425013 PMCID: PMC4564470 DOI: 10.4103/0972-2327.157251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Muscle involvement is a common manifestation of both clinical and subclinical hypothyroidism, with serum creatine kinase (CK) elevation being probably the most common manifestation, and is seen in up to 90% of patients, but is usually mild (less than 10 times the upper limit of normal). Rhabdomyolysis is a distinctively uncommon presentation of hypothyroidism described usually in the setting of precipitating events such as strenuous exercise, alcohol, or statin use. Rarely rhabdomyolysis and myoedema seen in hypothyroidism can be complicated by the development of anterior compartment syndrome leading to neurovascular compression. We describe a case of a patient with hypothyroidism who developed acute onset bilateral foot drop on initiation of statins. This case highlights the need for cautious use of statins in patients at risk for rhabdomyolysis.
Collapse
Affiliation(s)
- Neera Chaudhary
- Department of Neurology, Govind Ballabh Pant Hospital, New Delhi, India
| | | | - Prashant Makhija
- Department of Neurology, Govind Ballabh Pant Hospital, New Delhi, India
| | - Vinod Puri
- Department of Neurology, Govind Ballabh Pant Hospital, New Delhi, India
| | | |
Collapse
|
234
|
Suttels V, Florence E, Leys J, Vekemans M, Van den Ende J, Vlieghe E, Kenyon C. A 68-year old male presenting with rhabdomyolysis-associated acute kidney injury following concomitant use of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate and pravastatin/fenofibrate: a case report. J Med Case Rep 2015; 9:190. [PMID: 26347243 PMCID: PMC4562183 DOI: 10.1186/s13256-015-0671-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 08/11/2015] [Indexed: 01/10/2023] Open
Abstract
Introduction We present what we believe to be the first case in the literature of rhabdomyolysis-induced renal failure caused by a probable drug interaction between elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (EVG/COBI/FTC/TDF) and pravastatin/fenofibrate. Case presentation A 68-year old Caucasian man presented with progressive pain in both legs two weeks after commencing treatment with EVG/COBI/FTC/TDF. He was found to have biochemical evidence of rhabdomyolysis and acute renal failure. Conclusion We emphasize the need for post marketing surveillance of adverse effects of new products. Pharmacokinetic studies are necessary to investigate the levels of pravastatin in patients taking COBI and fenofibrate with and without other comorbidities. Meanwhile, we suggest that creatine kinase levels should be monitored and patients advised to report myalgias when using concomitant EVG/COBI/FTC/TDF and pravastatin/fenofibrate. This case serves as an important reminder to use estimated glomerular filtration rates rather than serum creatinine levels when choosing new medications. If potentially nephrotoxic combinations are started in patients with borderline estimated glomerular filtration rates, it may be prudent to check these filtration rates more frequently than usual. In patients with reduced estimated glomerular filtration rates, potentially nephrotoxic combinations should be avoided wherever possible.
Collapse
Affiliation(s)
- Veronique Suttels
- Tropical Disease Unit, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium.
| | - Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, Kronenburgstraat 43/3, 2000, Antwerp, Belgium.
| | - John Leys
- Department of Pharmacy, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium.
| | - Marc Vekemans
- Department of Clinical Sciences, Institute of Tropical Medicine, Kronenburgstraat 43/3, 2000, Antwerp, Belgium.
| | - Jef Van den Ende
- Tropical Disease Unit, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium. .,Department of Clinical Sciences, Institute of Tropical Medicine, Kronenburgstraat 43/3, 2000, Antwerp, Belgium.
| | - Erika Vlieghe
- Department of Clinical Sciences, Institute of Tropical Medicine, Kronenburgstraat 43/3, 2000, Antwerp, Belgium.
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Kronenburgstraat 43/3, 2000, Antwerp, Belgium.
| |
Collapse
|
235
|
Chang ZY, Boo AYY, Tulsidas H. Rhabdomyolysis: A rare complication of hypothyroidism. PROCEEDINGS OF SINGAPORE HEALTHCARE 2015. [DOI: 10.1177/2010105815598456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Hypothyroidism is known to be associated with muscle pain, weakness, stiffness and mildly elevated muscle enzymes. However, rhabdomyolysis due to hypothyroidism is very rare, especially in the absence of any precipitating factors, such as heavy exercise, alcohol or medication. We report a case of rhabdomyolysis associated with hypothyroidism in a 24-year-old man who presented with choking sensation, generalized lethargy, low backache and facial swelling with markedly raised muscle enzymes which normalized after thyroxine replacement.
Collapse
Affiliation(s)
- Zi Ying Chang
- Department of Internal Medicine, Singapore General Hospital, Singapore
| | | | - Haresh Tulsidas
- Department of Internal Medicine, Singapore General Hospital, Singapore
| |
Collapse
|
236
|
Frank L, Mann S, Johnson J, Levine C, Downey R, Griffits C, Wakshlag J. Plasma chemistry before and after two consecutive days of racing in sled dogs: associations between muscle damage and electrolyte status. COMPARATIVE EXERCISE PHYSIOLOGY 2015. [DOI: 10.3920/cep150020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Exercising long distance endurance sled dogs display plasma biochemistry changes characterised by elevations in creatine kinase (CK) and aspartate aminotransferase (AST), hypoproteinemia, hypoglobulinemia and decreases in sodium and potassium. The aim of this study was to compare resting to day 2 racing plasma biochemistry and associations between electrolytes and markers of muscle damage in well-conditioned sled dogs during a stage-stop race. Blood samples were obtained from 23 dogs prior to the start and on day 2, immediately after racing. Results showed significant decreases in potassium (day 0 – 4.7±0.3 and day 2 – 4.2±0.3 mEq/l), total protein (day 0 – 6.0±0.3 and day 2 – 5.5±0.4 g/dl) and albumin concentrations (day 0 – 3.9±0.2 and day 2 – 3.6±0.3 g/dl). Increases in AST (day 0 – 24±7 and day 2 – 137±97 U/l) and CK activities (day 0 – 129±39 and day 2 – 2,047±2,021 U/l) were also observed. Plasma sodium concentrations were not significantly different after day 2 of racing (day 0 – 153±5.2 and day 2 – 151±4.1). Alterations in plasma electrolytes, and increases in AST, CK, alanine aminotransferase and urea nitrogen were similar to those observed in long distance endurance sled dogs. A strong negative association was observed between plasma potassium and increases in plasma CK activity on day 2 (R2=0.69). The maintenance of sodium concentrations with a concurrent potassium decline, suggests sodium conservation via the renin-angiotensin-aldosterone pathway as previously shown in endurance sled dogs. The negative correlation between muscle damage and plasma potassium warrants further investigation regarding its relationship to rhabdomyolysis.
Collapse
Affiliation(s)
- L. Frank
- Cornell University Veterinary Specialists, 880 Canal Street, Stamford, CT 06902, USA
| | - S. Mann
- Cornell University College of Veterinary Medicine, Department of Population Medicine, Ithaca, NY 14853, USA
| | - J. Johnson
- Cornell University College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, NY 14853, USA
| | - C. Levine
- Cornell University College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, NY 14853, USA
| | - R. Downey
- Annamaet Petfood, 41 Daniels Road, Sellersville, PA 18960, USA
| | - C. Griffits
- Traveling Vet, 7640 W 1st St, Loveland, CO 80537, USA
| | - J. Wakshlag
- Cornell University College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, NY 14853, USA
| |
Collapse
|
237
|
|
238
|
|
239
|
Rhabdomyolysis-induced acute kidney injury in a cancer patient exposed to denosumab and abiraterone: a case report. BMC Nephrol 2015. [PMID: 26220655 PMCID: PMC4519001 DOI: 10.1186/s12882-015-0113-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Denosumab and abiraterone were approved by the United States Food and Drug Administration in 2011 for the treatment of metastatic castration-resistant prostate cancer. Neither denosumab nor abiraterone is known to cause rhabdomyolysis. Case presentation A 76-year-old Caucasian man with metastatic prostate cancer presented with non-oliguric severe acute kidney injury (AKI) 3 weeks after receiving simultaneous therapy with denosumab and abiraterone. The patient had been on statin therapy for more than 1 year with no recent dose adjustments. His physical exam was unremarkable. Blood work on admission revealed hyperkalemia, mild metabolic acidosis, hypocalcemia, and elevated creatine kinase (CK) at 44,476 IU/L. Kidney biopsy confirmed the diagnosis of rhabdomyolysis-induced AKI. The patient responded well to intravenous isotonic fluids and discontinuation of denosumab, abiraterone, and rosuvastatin, with normalization of CK and recovery of kidney function. Conclusion We report the first case of biopsy-proven rhabdomyolysis-induced AKI in a cancer patient acutely exposed to denosumab and abiraterone. Whether one of these drugs individually, or the combination, was the bona fide culprit of muscle breakdown is unknown. Nonetheless, our report is hypothesis-generating for further investigations on the effect of these drugs on muscle cells.
Collapse
|
240
|
Restrepo D, Montoya P, Giraldo L, Gaviria G, Mejía C. [Rhabdomyolysis in a Bipolar Adolescent. Analysis of Associated Factors]. REVISTA COLOMBIANA DE PSIQUIATRIA 2015; 44:183-8. [PMID: 26578419 DOI: 10.1016/j.rcp.2015.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 01/29/2015] [Accepted: 02/02/2015] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To describe a case of rhabdomyolysis associated with the use of quetiapine and lamotrigine in an adolescent treated for bipolar disorder. METHOD Description of the clinical case, analysis of the associated factors and a non-systematic review of the relevant literature. RESULTS An 18 year old male, with bipolar disorder and treated pharmacologically with quetiapine and lamotrigine, after two weeks of physical activity presents with rhabdomyolysis. Quetiapine and exercise have been associated with rhabdomyolysis. The mediator mechanism of this association has not been found, although it has been established that there is neuromuscular dysfunction and an increase in sarcomere permeability. CONCLUSIONS This clinical case allowed the complex interaction between antipsychotic agents and increased physical activity to be observed in a psychiatric adolescent patient, as well as the appearance of a potentially lethal medical complication.
Collapse
|
241
|
Abstract
PURPOSE OF REVIEW Clinically identified myopathies are frequently a consequence of medication toxicities. However, recognizing drug-induced myopathies is sometimes difficult. Developing a greater understanding of the underlying mechanisms of drug-induced muscle toxicity will promote enhanced awareness and recognition, and improved management of these syndromes. RECENT FINDINGS The adverse impact of certain drugs on muscle metabolism, muscle cell atrophy, and myocyte apoptosis is increasingly clear. Glucocorticoids impair glucose handling and directly promote protein catabolism. Statins impair mitochondrial function and alter intracellular signaling proteins, which can lead to myocyte apoptosis. Alternatively, statins can induce an autoimmune necrotizing myositis. Several medications impair autophagy, thus limiting access to the needed glycogen stores. SUMMARY This review provides an overview of the main underlying mechanisms of drug-induced myopathies. These myopathies will most often be related to a drug's ability to alter metabolism and protein balance, induce necrosis, or impair autophagy.
Collapse
|
242
|
Abstract
Numerous genetic and non-genetic factors contribute to aging. To facilitate the study of these factors, various descriptors of biological aging, including 'successful aging' and 'frailty', have been put forth as integrative functional measures of aging. A separate but related quantitative approach is the 'frailty index', which has been operationalized and frequently used. Various frailty indices have been constructed. Although based on different numbers and types of health variables, frailty indices possess several common properties that make them useful across different studies. We have been using a frailty index termed FI34 based on 34 health variables. Like other frailty indices, FI34 increases non-linearly with advancing age and is a better indicator of biological aging than chronological age. FI34 has a substantial genetic basis. Using FI34, we found elevated levels of resting metabolic rate linked to declining health in nonagenarians. Using FI34 as a quantitative phenotype, we have also found a genomic region on chromosome 12 that is associated with healthy aging and longevity.
Collapse
Affiliation(s)
- Sangkyu Kim
- Tulane Center for Aging and Department of Medicine, Tulane University Health Sciences Center, New Orleans, LA, USA
| | - S. Michal Jazwinski
- Tulane Center for Aging and Department of Medicine, Tulane University Health Sciences Center, New Orleans, LA, USA
| |
Collapse
|
243
|
Horwitz H, Woeien VA, Petersen LW, Jimenez-Solem E. Hypokalemia and rhabdomyolysis. J Pharmacol Pharmacother 2015; 6:98-9. [PMID: 25969658 PMCID: PMC4419257 DOI: 10.4103/0976-500x.155488] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 03/21/2014] [Accepted: 09/11/2014] [Indexed: 11/25/2022] Open
Abstract
The adverse drug event manager of the Capital Region of Denmark received a report of a 65-year-old male with type II diabetes and long-lasting treatment with indapamide. In addition, he had a history of a high consumption of licorice. For 2 weeks, the patient suffered from myalgia, which the general practitioner suspected to be polymyalgia rheumatica and referred him to the hospital. Initial blood samples revealed a reduced potassium concentration of 1.5 mmol/L (reference value: 6.6-4.6 mmol/L) and an elevated creatine kinase of 18,400 IU/L (reference value: 40-280 IU/L). We believe that the patient developed rhabdomyolysis due to severe hypokalemia, possibly induced by a pharmacodynamic interaction between licorice and indapamide.
Collapse
Affiliation(s)
- Henrik Horwitz
- Department of Clinical Pharmacology, Bispebjerg Hospital, University of Copenhagen, Denmark
| | - Vidar A Woeien
- Department of Clinical Pharmacology, Bispebjerg Hospital, University of Copenhagen, Denmark
| | - Linda Wiuff Petersen
- Department of Internal Medicine, Bispebjerg Hospital, University of Copenhagen, Denmark
| | - Espen Jimenez-Solem
- Department of Clinical Pharmacology, Bispebjerg Hospital, University of Copenhagen, Denmark
| |
Collapse
|
244
|
Loens S, Conzen J, Welte GS, Scharn N, Schrader C, Weissenborn K. Reversible posterior leukoencephalopathy syndrome after withdrawal of antipsychotic medication in the context of lithium intoxication. Gen Hosp Psychiatry 2015; 37:274.e3-5. [PMID: 25794475 DOI: 10.1016/j.genhosppsych.2015.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 02/25/2015] [Accepted: 02/27/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report a case of reversible posterior leukoencephalopathy syndrome (RPLS) after withdrawal of antipsychotic medication in a patient with acute lithium intoxication. METHODS Case report. RESULTS A patient with schizoaffective disorder was admitted with lithium intoxication, rhabdomyolysis and acute renal failure. After withdrawal of psychotropic medication, she developed a significant increase in blood pressure - though to moderately hypertensive levels - and prolonged disturbance of consciousness with profound agitation. MRI revealed RPLS. Resumption of antipsychotic treatment resulted in significant drop of blood pressure and improvement. CONCLUSION Acute withdrawal of antipsychotic medication may lead to rebound hypertension and development of RPLS, especially in the presence of lithium intoxication and renal dysfunction.
Collapse
Affiliation(s)
- Sebastian Loens
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Josef Conzen
- Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Gabriel Simon Welte
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Nicole Scharn
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Christoph Schrader
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Karin Weissenborn
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| |
Collapse
|
245
|
High Risk of Rhabdomyolysis and Acute Kidney Injury After Traumatic Limb Compartment Syndrome. Ann Plast Surg 2015; 74 Suppl 2:S158-61. [DOI: 10.1097/sap.0000000000000460] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
246
|
Abstract
OBJECTIVE To report a case of recurrent hyponatremia and rhabdomyolysis in a teenager with psychogenic polydipsia. CASE SUMMARY A 16-year-old boy was admitted with recurrent episodes of hyponatremia and rhabdomyolysis secondary to psychogenic polydipsia. He was treated with hypertonic saline, intravenous fluids, and supportive care. DISCUSSION Psychogenic polydipsia is a condition characterized by compulsive drinking. Severe hyponatremia is a rare, but serious complication in patients with psychogenic polydipsia. Failure in cell volume regulatory mechanisms, defective osmoregulation, defective urinary dilution, and enhanced secretion of vasopressin are believed to play a role in the development of hyponatremia. Rhabdomyolysis can complicate severe hyponatremia, although the exact mechanism is not known. Antipsychotic drugs are also implicated in rhabdomyolysis. CONCLUSIONS Severe hyponatremia and rhabdomyolysis can complicate psychogenic polydipsia. Patients receiving antipsychotic drugs with concomitant severe hyponatremia need to be monitored for rhabdomyolysis.
Collapse
|
247
|
Abstract
Rhabdomyolysis is characterized by severe acute muscle injury resulting in muscle pain, weakness, and/or swelling with release of myofiber contents into the bloodstream. Symptoms develop over hours to days after an inciting factor and may be associated with dark pigmentation of the urine. Serum creatine kinase and urine myoglobin levels are markedly elevated. Clinical examination, history, laboratory studies, muscle biopsy, and genetic testing are useful tools for diagnosis of rhabdomyolysis, and they can help differentiate acquired from inherited causes of rhabdomyolysis. Acquired causes include substance abuse, medication or toxic exposures, electrolyte abnormalities, endocrine disturbances, and autoimmune myopathies. Inherited predisposition to rhabdomyolysis can occur with disorders of glycogen metabolism, fatty acid β-oxidation, and mitochondrial oxidative phosphorylation. Less common inherited causes of rhabdomyolysis include structural myopathies, channelopathies, and sickle-cell disease. This review focuses on the differentiation of acquired and inherited causes of rhabdomyolysis and proposes a practical diagnostic algorithm. Muscle Nerve 51: 793-810, 2015.
Collapse
Affiliation(s)
- Jessica R Nance
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrew L Mammen
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Building 50, Room 1146, Bethesda, Maryland, 20892, USA
| |
Collapse
|
248
|
Scarpato S, Atzeni F, Sarzi-Puttini P, Brucato A, Quartuccio L, Pietrogrande M, Monti G, Galli M. Pain management in cryoglobulinaemic syndrome. Best Pract Res Clin Rheumatol 2015; 29:77-89. [DOI: 10.1016/j.berh.2015.04.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2015] [Indexed: 01/26/2023]
|
249
|
Horazeck C, Huh AS, Huh BK. Acute Rhabdomyolysis in a Patient with Long-Term Exposure to Intrathecal Ziconotide: A Case Report. Pain Pract 2015; 15:E34-9. [DOI: 10.1111/papr.12273] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 11/02/2014] [Indexed: 01/04/2023]
Affiliation(s)
- Christian Horazeck
- Department of Anesthesiology; Duke University Medical Center; Durham North Carolina U.S.A
| | | | - Billy K. Huh
- Department of Pain Medicine; The University of Texas MD Anderson Cancer Center; Houston Texas U.S.A
| |
Collapse
|
250
|
Kakiuchi S, Yakushijin K, Yamamoto K, Tomioka H, Inui Y, Okamura A, Kawamoto S, Minami Y, Murayama T, Ito M, Matsuoka H, Minami H. Rhabdomyolysis Caused by Candida parapsilosis in a Patient with Acute Myeloid Leukemia after Bone Marrow Transplantation. Intern Med 2015; 54:2057-60. [PMID: 26278302 DOI: 10.2169/internalmedicine.54.4136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Rhabdomyolysis is characterized by a marked elevation of the creatine kinase (CK) levels and myoglobinuria, thus leading to renal dysfunction. Various viruses or bacteria can be etiologic agents, but mycosis has only rarely been reported to be a cause of rhabdomyolysis. In this report, we describe an adolescent male with acute myeloid leukemia who underwent allogeneic bone marrow transplantation and thereafter developed rhabdomyolysis and Candida parapsilosis fungemia almost at the same time. Following treatment for C. parapsilosis, the transaminase and CK levels both satisfactorily decreased. This case illustrates that C. parapsilosis infection may be a causative agent of rhabdomyolysis in immunocompromised patients.
Collapse
Affiliation(s)
- Seiji Kakiuchi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|