Tetanus as a cause of acute renal failure: possible role of rhabdomyolysis

A Man With Intractable Convulsion

“…Complications of tetanus, as the case with our patient, include autonomic instability and rhabdomyolysis with renal failure. 8 , 9 Excessive catecholamine release can cause hypertension and tachycardia alternating with bradycardia and hypotension. Medications that lead to adrenergic blockade and inhibition of autonomic reactivity are the proper management to achieve control of autonomic function.…”

Diretrizes para o manejo do tétano acidental em pacientes adultos

“…No correlation between CPK levels and kidney injury has been shown. (104,105) Other potential causes, such as hypovolemia, sepsis, nephrotoxic drugs and (especially) dysautonomia, are apparently more relevant. (105,106) Therefore, daily monitoring of CPK levels is not justified for the early detection of rhabdomyolysis or for the prevention of renal injury prevention.…”

Acute Renal Failure in Tetanus

“…Autonomic dysfunction, most evident in first two wk of illness, has been proposed to be the primary culprit in causing AKI [1]. No correlation was previously found between serum/urine myoglobin and ARF [1,2]. However, no patient in these studies had gross myoglobinuria, and in the study that measured serum myoglobin, levels were below renal threshold, explaining apparent non correlation [3].…”

“…Acute Kidney Injury (AKI) is a known, though not very well described, complication of tetanus; occurring in 15-39 % cases. We report AKI and myoglobinuria in a child with tetanus, and discuss pertinent issues [1,2].…”

“…AKI has been previously described as a complication of tetanus. The renal dysfunction is reported to be mild and non-oliguric [1,2]. Suggested pathophysiological mechanisms include autonomic dysfunction, and rhabdomyolysis due to uncontrolled muscle spasms.…”