Psychosis-Induced Rhabdomyolysis

Coryell, William; Norby, L.H.; Cohen, Loren H.

doi:10.1016/s0140-6736(78)92987-2

Cited by 21 publications

(7 citation statements)

References 19 publications

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“…Nevertheless, several risk factors make psychiatric patients vulnerable to develop rhabdomyolysis. These factors include catatonia, agitation, alcohol abuse, and neuroleptics (Coryell et al, 1978;Gabow et al, 1982;Johnson et al, 1987;Jermain and Crismon, 1992;Daher et al, 2005). In a study of 77 patients aged 21-85 years who developed rhabdomyolysis, eight patients of unspecified age died (Gabow et al, 1982).…”

Section: Dear Editormentioning

confidence: 99%

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Rhabdomyolysis associated with mania in late life

Kotbi

Mahgoub

Mokonogho

et al. 2009

Int J Geriat Psychiatry

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Section: Dear Editormentioning

confidence: 99%

“…The incidence of rhabdomyolysis in psychiatric patients is not known (1). Nevertheless, several risk factors make psychiatric patients more vulnerable to develop rhabdomyolysis and these factors include catatonia, agitation, alcohol abuse, and neuroleptic medications (1) (2) (4) (5). …”

Section: Introductionmentioning

confidence: 99%

Rhabdomyolysis associated with mania in late life

Kotbi

Mahgoub

Mokonogho

et al. 2009

Int J Geriat Psychiatry

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“…There is a report of psychosisinduced rhabdomyolysis unassociated with drug ingestion and was probably related to a period of 'sustained, intense isometric muscle contractions'. 4 Neuropsychiatric manifestations are also found in patients with acute porphyria. The diagnosis of acute porphyria in a patient with rhabdomyolyis is unusual and there has been only one other report in the literature.…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis in a patient with acute intermittent porphyria

Marsden

Peters

2004

Ann Clin Biochem

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There are several conditions associated with rhabdomyolysis, such as direct muscle injury, viral infections, metabolic disorders and toxic effects from ingestion of drugs such as alcohol, opiates, cocaine or heroin. We report on a patient who was admitted to the accident and emergency unit with a clinical presentation of rhabdomyolysis and acute intermittent porphyria.Ann Clin Biochem 2004; 41: 341-343 Case reportA 19-year-old Afro-Caribbean woman presented to her general practitioner with lower back pain and vomiting for 3 days. She had a history of dysuria and constipation and was given non-steroidal antiin£ammatory drugs, antibiotics for a possible urinary tract infection (subsequent urine culture was negative) and analgesia. Her symptoms had not resolved by late evening and she attended her local accident and emergency department (A&E). Her renal and liver function were normal, although she was clinically dehydrated with a serum urea 7.5 mmol/L (reference range 3.3^6.7 mmol/L) (seeTable 1), and she was given intravenous £uid replacement. She had a normochromic normocytic anaemia with a haemoglobin 98 g/L, her white blood count was normal and the only other biochemical abnormality was a slightly raised serum amylase of 164 IU/L (5100). A second visit to A&E the next evening showed similar biochemistry except that serum sodium 130 mmol/L was below the reference range (135^145 mmol/L). A di¡erential diagnosis of appendicitis, ovarian cyst or pelvic in£ammatory disease was made. Her chest Xray was normal and urine microscopy did not reveal any abnormality. A subsequent visit to A&E two evenings later caused some concern as the patient had raised serum creatinine 161 mmol/L (45^120 mmol/L) and aspartate aminotransferase (AST) 530 IU/L (105 0 IU/L). In view of the raised serum AST further biochemical investigations revealed a very high creatine kinase (CK) 57 400 IU/L (0^150 IU/L). Additional tests were requested to ¢nd the cause of the rhabdomyolysis and the unresolved abdominal pain. These included routine porphyrin analysis, drugs of abuse screen, paracetamol, thyroid and cortisol measurements. Urine myoglobin was not requested, as it is not recommended practice to screen urine for the presence of myoglobin. 1 The urine specimen received for porphyrin analysis was not pigmented although it was a dilute urine specimen with a urine creatinine of 2.1mmol/L. There was no history of alcohol abuse, with consistent denial of the use of illicit drugs. Porphyrin analysis showed a marked increase in urinary 5-aminolaevulinic acid (ALA) and urinary porphobilinogen (PBG). Table 2 shows the urinary porphyrin excretion during her stay in hospital and following attendance at the porphyria clinic. Erythrocyte hydroxymethylbilane synthase (HMBS) activity, 19 nmol uroporphyrin per mL red cells per h at 378C, was below the reference range (20^42 nmol/ mL/h), plasma £uorescence spectrophotometry showed a peak characteristic of porphyrin with an emission maximum at 621nm and no excess porphyrins were detected in the faec...

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“…Other studies have reported an association between psychosis (eg, mania and schizophrenia) involving overactivity, catatonia and rhabdomyolysis. [37][38][39] In sum, the literature appears to suggest some association between the state of excited delirium, rhabdomyolysis, NMS and even catatonia. Studies have also noted that NMS and catatonia seem to be different aspects of the same syndrome (cf, Fink; 40 Carroll; 41 Koch and colleagues 42 ).…”

Section: Rhabdomyolysis Neuroleptic Malignant Syndrome and Catatoniamentioning

confidence: 99%

Excited delirium: Consideration of selected medical and psychiatric issues

Samuel

Williams²,

Ferrell³

2009

NDT

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Excited delirium, sometimes referred to as agitated or excited delirium, is the label assigned to the state of acute behavioral disinhibition manifested in a cluster of behaviors that may include bizarreness, aggressiveness, agitation, ranting, hyperactivity, paranoia, panic, violence, public disturbance, surprising physical strength, profuse sweating due to hyperthermia, respiratory arrest, and death. Excited delirium is reported to result from substance intoxication, psychiatric illness, alcohol withdrawal, head trauma, or a combination of these. This communication reviews the history of the origins of excited delirium, selected research related to its causes, symptoms, management, and the links noted between it and selected medical and psychiatric conditions. Excited delirium involves behavioral and physical symptoms that are also observed in medical and psychiatric conditions such as rhabdomyolysis, neuroleptic malignant syndrome, and catatonia. A useful contribution of this communication is that it links the state of excited delirium to conditions for which there are known and effective medical and psychiatric interventions.

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Psychosis-Induced Rhabdomyolysis

Cited by 21 publications

References 19 publications

Rhabdomyolysis associated with mania in late life

Rhabdomyolysis associated with mania in late life

Rhabdomyolysis in a patient with acute intermittent porphyria

Excited delirium: Consideration of selected medical and psychiatric issues

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