Sauna-Induced Fatal Rhabdomyolysis

Zhuo, Min; William, Jeffrey H.

doi:10.1016/j.ekir.2018.08.008

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…23 and Zhuo et al. 26 reported renal impairment. No studies have reported the simultaneous presence of muscle pain (myalgia), dark urine, and muscle weakness.…”

Section: Resultsmentioning

confidence: 97%

“…Of the 126 studies found through the search strategy, 10 met the proposed inclusion criteria and were in compliance with the CARE recommendations.Of the 10 articles selected to compose the present review, two reported cases of soccer athletes, 23,25 three of football, 17,19,21 two of swimming, 22,24 one of wrestling, 20 one of 24-hour cross-country skiing, 18 and one of mixed martial arts (MMA). 26 Of the six modalities described in the studies, four presented characteristics of physical contact sports (soccer, football, wrestling, and MMA) and two were related to individuals sports (skiing and swimming).The age range of the athletes varied between 16 to 41 years old. The case reports described a total of 17 athletes of whom 14 were male, and three were female.The characteristics of participants included in the case reports are summarized in Table 3.…”

Section: Resultsmentioning

confidence: 99%

“…One of the studies 19 selected for the present systematic review presented cases with CK levels lower than or equal to 5.000 U/L.Nonetheless, two other studies reported the occurrence of impaired renal functions. 23,26 The first one 23 was not clear about the impairment and whether renal failure actually occurred, while the second one 26 classified as “acute kidney injury”.…”

Section: Discussionmentioning

confidence: 99%

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Case reports of athletes affected by rhabdomyolysis: A systematic review

Dantas

Nunes

Casimiro-Lopes

et al. 2021

International Journal of Sports Science & Coaching

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Objective To analyze intensity levels, modalities, types of physical activities, ambient temperature, and hydration levels during stimuli performed in training and competitionof studies that reported episodes of rhabdomyolysis in athletes. Method We conducted a systematic review following the PRISMA guidelines and registered on PROSPERO, as number CRD42020126107. MedLine (via PubMed), Cochrane, LILACS, SciELO, Web of Science, Scopus, CINAHL, SPORTDiscus, ScienceDirect, and PEDro databases were searched for case reports in which professional athletes, who had a technical team as support, were affected by rhabdomyolysis induced by the practice of physical activity. The descriptors and their synonyms “rhabdomyolysis”, “exercise”, and “athletes”, available in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), were used. Results After the screening process, 10 studies were includedand analyzed according to the CAse REport (CARE) guidelines.The sports of the case reports were soccer, football, swimming, wrestling, 24-hour cross-country skiing, and mixed martial arts (MMA).The age range of the athletes varied between 16 to 41 years old. The case reports described a total of 17 athletes (14 male and three female).The main aspects related to the diagnosis of rhabdomyolysis were ambient temperature, creatine kinase (CK) levels, the occurrence of renal impairment, and one or more signs of the classical triad (myalgia, dark urine, and muscle weakness). Conclusion It was observed difficulty in identifying concrete parameters to prevent and diagnose the rhabdomyolysis of premature form, however, controlling these variables may increase the chances of treatment success and decrease the risk of sequels.

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“…23 and Zhuo et al. 26 reported renal impairment. No studies have reported the simultaneous presence of muscle pain (myalgia), dark urine, and muscle weakness.…”

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Case reports of athletes affected by rhabdomyolysis: A systematic review

Dantas

Nunes

Casimiro-Lopes

et al. 2021

International Journal of Sports Science & Coaching

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“…Fatal rhabdomyolysis secondary to RWL has been reported 4 . We believe the patient presented by Zhuo and associates 1 was also a victim of RWL. Unfortunately, these cases in the medical journals are just the tip of the iceberg.…”

mentioning

confidence: 77%

“…We read the case entitled “Sauna-Induced Fatal Rhabdomyolysis” by Zhuo et al. 1 with interest. The authors described a mixed martial arts combatant with a history of sauna use before a fight.…”

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confidence: 99%

Another Victim of Rapid Weight Loss?

Helvacı

Korucu

Arınsoy

2019

Kidney International Reports

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To the Editor: We read the case entitled "Sauna-Induced Fatal Rhabdomyolysis" by Zhuo et al. 1 with interest. The authors described a mixed martial arts combatant with a history of sauna use before a fight. The patient died due to rhabdomyolysis-induced hyperkalemia. The authors underlined sauna use, dehydration, hyperthermia, strenuous activity, and sickle cell trait as risk factors for rhabdomyolysis. We believe there is one more teaching point in this case: rapid weight loss (RWL). RWL, that is, "weight cutting," is a common practice in weight-sensitive sports. Athletes lose 10% to 15% of body weight in the day/week before tournaments. Salt baths, use of plastic suits, sauna, and other techniques are frequently used before weigh-ins. 2 In a current survey, 88% to 97% of all martial arts fighters admitted practicing RWL. 3 Fatal rhabdomyolysis secondary to RWL has been reported. 4 We believe the patient presented by Zhuo and associates 1 was also a victim of RWL. Unfortunately, these cases in the medical journals are just the tip of the iceberg. In addition to excellent coverage of rhabdomyolysis by the authors, health issues regarding RWL are worth mentioning. Hypoglycemia, electrolyte abnormalities, severe dehydration (e.g., kidney injury, hypotension, syncope) have been reported in acute settings. Hormonal disturbances, insulin resistance, and increased cardiovascular risk are possible long-term consequences. 2 Physicians should be aware of the concept of RWL and associated risks.

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