Clinical Features of Acute Rhabdomyolysis in 55 Pediatric Patients

Abstract

Objective: This study was designed to compare the clinical manifestations, laboratory tests, etiology, and prognosis of children with acute rhabdomyolysis (RM) at various ages. This study was designed to analyze the risk factors for acute kidney injury (AKI) in children with RM and to identify the role of neuromuscular and autoimmune disease in children with RM. Methods: Clinical data for 55 children with RM were collected and statistically analyzed. Patients were stratified to an infant group (G1) (age <1 year), preschool group (G2) (age 1-6 year), school-age group (G3) (age 7-11 year), and an adolescent group (G4) (age 12-16 year). Results: The top three clinical manifestations were dark urine (52.7%), myalgia (38.2%), and fever (23.8%). Patients in G1 had fever (71.4%), vomiting (77.8%), and urinalysis abnormalities (14.3%), without triad clinical manifestations. Fifty percent of patients in G4 group had myalgia; 70.8% had dark urine; 75% had abnormal urine tests. The most common cause in each age group was as follows: sepsis (57.1%) in G1; hereditary neuromuscular diseases (44.4%) in G2; immune diseases (40%) in G3; strenuous exercise (50%) in G4. Logistic regression analysis shown that AKI was not corelated with age, gender, or peak creatine phosphokinase. AKI was, however, associated with presence of an electrolyte disorder. Conclusion: The clinical manifestations and laboratory findings in infants with acute RM are not typical and need to be taken seriously. The presence of an electrolyte disorder is a risk factor for AKI in children with RM. The most common pathogenesis of RM varies among age groups. Congenital hereditary metabolic disease and immune diseases should not be ignored as a cause of RM in children.

Acute Rhabdomyolysis in a Child with Multiple Suspicious Gene Variants

“…This manuscript presents a case of severe rhabdomyolysis in a thirteen-month-old patient. This degree of rhabdomyolysis with a CK value of 145,920 U/L has been rarely reported in this age group, and not all of them made a complete recovery without renal replacement therapy [ 2 – 4 ]. Forced alkaline diuresis was helpful in our patient, but it also led to pulmonary edema.…”

“…e diagnosis of rhabdomyolysis is considered when the CK value exceeds 1000 U/L or at least ten times the normal upper limit [1]. Cardinal causes in the pediatric population include viral myositis, trauma, seizures, physical exertion, medications, intoxication, dystonia, and genetic and metabolic disorders [1][2][3][4][5].…”

“…The degree of muscle involvement seems to impact the CK level, and superior levels can be associated with unfavorable outcomes [ 2 , 3 , 5 ]. Acute renal failure has been reported in as high as 42% of cases [ 3 ] with up to 11% mortality [ 4 ]. The outcomes of rhabdomyolysis can be more detrimental in the pediatric population, although the incidence remains lower than that in adults.…”

Anesthetic Challenges in a Patient With TANGO2 Gene Deletion, DiGeorge Syndrome, and Tetralogy of Fallot: A Case Report

“…2 The resultant disease is characterized by long-term neurological decline, interspersed with acute metabolic crises during times of stress (Tables 1-2). 1-6…”

“…2 The resultant disease is characterized by long-term neurological decline, interspersed with acute metabolic crises during times of stress (Tables 1-2). [1][2][3][4][5][6] Clinical sequelae during a metabolic crisis may include hypoglycemia, rhabdomyolysis, lactic acidosis, kidney injury, hypothyroidism, dysphagia, encephalopathy, seizures, and cardiac dysfunction. 1,3,7 Life-threatening arrhythmias are common during periods of metabolic stress, often starting with marked prolongation of the QT interval and progressing to torsades de pointe or ventricular tachycardia.…”