Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report
| Autor: | Mashal Salehi, Afua Kunadu, Pavan Luckoor |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Substance-Related Disorders Legionnaires’ Disease Alcohol abuse Urine 030204 cardiovascular system & hematology Rhabdomyolysis 03 medical and health sciences 0302 clinical medicine Cocaine Internal medicine Sepsis medicine Pneumonia Bacterial Humans Intensive care medicine Creatine Kinase Past medical history Legionellosis biology business.industry Acute kidney injury General Medicine Articles Acute Kidney Injury medicine.disease Pneumonia Diarrhea 030220 oncology & carcinogenesis biology.protein Creatine kinase medicine.symptom business |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| Popis: | Patient: Male, 36 Final Diagnosis: Rhabdomyolysis induced acute renal failure Symptoms: Diarrhea • generalized weakness Medication: — Clinical Procedure: Hemodialysis • intubation Specialty: Critical Care Medicine Objective: Unusual setting of medical care Background: Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure. Case Report: A 36-year-old African American male patient with no significant past medical history and a social history of cocaine and alcohol abuse presented with diarrhea and generalized weakness of 2 days’ duration. He was found to be febrile, tachycardic, tachypneic, and hypoxic. The patient was subsequently intubated and admitted to the medical ICU. Laboratory work-up showed acute renal failure with deranged liver functions test results, and elevated creatine kinase of 701,400 U/L. CK levels were subsequently too high for the lab to quantify. Urine legionella testing was positive for L. pneumophilia serogroup 1 antigen and urine toxicology was positive for cocaine. The patient had a protracted course in the ICU. He was initially started on CVVH, and later received intermittent hemodialysis for about 1 month. Conclusions: In the presence of multiple etiologic factors, rhabdomyolysis can be massive with resultant significant morbidity. Clinicians should have a high index of suspicion for rhabdomyolysis in the presence of multiple factors, as early recognition of this diseases is very important in the prevention and active management of life-threatening conditions. |
| Databáze: | OpenAIRE |
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