Causes of rhabdomyolysis in acute poisonings

Jankovic, Snezana; Jovic-Stosic, Jasmina; Vučinić, Slavica; Perković-Vukčević, Nataša; Vuković-Ercegović, Gordana

doi:10.2298/vsp1311039j

Cited by 18 publications

(11 citation statements)

References 35 publications

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“…Anti-psychotic medications that trigger the neuroleptic malignant syndrome are a notable cause of rhabdomyolysis in series of adults and children 4, 44, 45 and in multiple case reports recently reviewed by Packard, et al 46 . Among the psychiatric medications, antidepressants have also been associated with rhabdomyolysis 47, 48 .…”

Section: Acquired Causes Of Rhabdomyolysismentioning

confidence: 99%

Diagnostic evaluation of rhabdomyolysis

2015

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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 following an inciting factor and may be associated with dark pigmentation of the urine. Serum creatine kinase and urine myoglobin levels are markedly elevated. The 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 disturbance, and autoimmune myopathies. Inherited predisposition to rhabdomyolysis can occur with disorders of glycogen metabolism, fatty acid beta-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.

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Section: Acquired Causes Of Rhabdomyolysismentioning

confidence: 99%

Diagnostic evaluation of rhabdomyolysis

2015

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“…Rarely, rhabdomyolysis and renal insufficiency can be seen clinically in severe cases. 8,9 Diagnosis is based on medical history, physical examination, and COHb level. Hyperbaric oxygen therapy (HBOT) can be applied in severe cases in addition to oxygen and supportive therapy.…”

Section: Introductionmentioning

confidence: 99%

Factors that Affect Prognosis and Morbidity in Pediatric Patients with Carbon Monoxide Poisoning

Seçilmiş¹,

Öztürk²

2018

cayd

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Carbonmonoxide poisoning continues to be a major health problem worldwide, especially in developing countries, and constitutes an important part of the patients admitted to the pediatric emergency clinics due to poisoning. The aim of this study was to evaluate the correlation between clinical severity, morbidity, hospital stay, intensive care need, and full systemic effects in patients who were followed up and treated for carbon monoxide poisoning in our pediatric emergency clinic. Methods: The study was performed between January 2013 and 2015. We included patients under 18 years of age who were admitted to the pediatric emergency with carbon monoxide poisoning. Assessments were made prospectively. The epidemiological characteristics, complaints, physical examination and vital findings of all patients were recorded. Carboxyhemoglobin (COHb) level, oxygen saturation, electrocardiography, complete blood count, liver and kidney functions, and cardiac enzymes were studied, and Glasgow Coma scale (GCS) was calculated. Results: The mean length of hospital stay for 232 patients was calculated as 7.08±1 hours and the mean duration of exposure to carbon monoxide gas was 3.17±2.5 hours. Higher COHb levels and cardiotoxicity were detected in patients with a longer duration of exposure and a lower GCS and an increased intensive care need (p<0.01). There was no correlation between COHb levels and clinical severity, GCS, or intensive care unit need. However, it was found that high COHb levels (especially above 30%) increased cardiac injury and neurological symptoms but did not cause a permanent sequela (p<0.05). None of the patients had permanent neurological, cardiac, or renal damage. Conclusion: We found that duration of exposure is the most important and accurate parameter for the evaluation of clinical course and morbidity. In patients with high COHb levels, the effects are more prominent, however, we considered that there was no change in sequelae at long-term follow up.

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“…Ethanol causes rhabdomyolysis through disruption of Adenosine triphosphates pump function, break down of the muscle membrane, alteration of the sarcoplasmic reticulum, sodium permeability and disrupting calcium homeostasis, inducing cytokine releasing the levels of "interleukin (IL) 1, IL-2, IL-6", and" tumor necrosis factor α" (8)(9)(10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

“…The resulting hyperkalemia may increase the risk for cardiac arrhythmia and complicate an existing acute renal failure (1)(2)(3). Rhabdomyolysis is caused by a wide variety of conditions, including trauma, drugs, viruses, and metabolic disorders (7,8). Rhabdomyolysis is a potentially fatal condition, with a mortality rate of approximately 8% (7).…”

Section: Introductionmentioning

confidence: 99%

Alcohol Induced Rhabdomyolysis

Zahiroddin

Rezaei

2016

Iran J Psychiatry Behav Sci

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Rhabdomyolysis is a common condition with potentially devastating complications, and only few therapeutic options are available for the treatment of acute Rhabdomyolysis. In this case, a 56-year-old male who had been drinking alcohol, presented to the emergency department for evaluation of slurred speech, ataxic gait, mood instability, and cognitive disorder. On admission, his creatine kinase (CK) level was 2882 U/L. Despite aggressive fluid repletion, his CK level continued to increase, peaking at 11350 U/L. On administration and after the fluid transfusion with isotonic saline, his CK levels and clinical symptoms improved dramatically. We report this case as it is a rare condition of rhabdomyolysis due to alcohol, with the intent to highlight its clinical features and paraclinical finding.

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Causes of rhabdomyolysis in acute poisonings

Cited by 18 publications

References 35 publications

Diagnostic evaluation of rhabdomyolysis

Diagnostic evaluation of rhabdomyolysis

Factors that Affect Prognosis and Morbidity in Pediatric Patients with Carbon Monoxide Poisoning

Alcohol Induced Rhabdomyolysis

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