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Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report

RATIONALE: Rhabdomyolysis can be an uncommon complication of coronavirus disease 2019 (COVID-19) infection. However, the diagnosis of rhabdomyolysis could be easily missed due to its atypical clinical presentations. We present a patient with a history of end-stage renal disease (ESRD) who contracted...

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Autores principales: Lu, Wenhui, Li, Xiaoying, You, Wenyi, Gong, Rui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695608/
http://dx.doi.org/10.1097/MD.0000000000036360
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author Lu, Wenhui
Li, Xiaoying
You, Wenyi
Gong, Rui
author_facet Lu, Wenhui
Li, Xiaoying
You, Wenyi
Gong, Rui
author_sort Lu, Wenhui
collection PubMed
description RATIONALE: Rhabdomyolysis can be an uncommon complication of coronavirus disease 2019 (COVID-19) infection. However, the diagnosis of rhabdomyolysis could be easily missed due to its atypical clinical presentations. We present a patient with a history of end-stage renal disease (ESRD) who contracted COVID-19 and subsequently developed rhabdomyolysis. We discuss and share our experience in the management of this patient. PATIENT CONCERNS: An 85-year-old male with ESRD undergoing routine hemodialysis was tested positive for COVID-19. The patient had clinical symptoms of fatigue, muscle pain, and difficulty walking. DIAGNOSIS: The serum creatine kinase (CK) level was markedly elevated to 32,492.9U/L, supporting the diagnosis of rhabdomyolysis. A computed tomography scan revealed muscle injuries throughout the body, confirming the diagnosis. INTERVENTIONS: The patient was managed through electrolyte corrections and continuous renal replacement therapy. OUTCOMES: Repeat tests showed decreased levels of serum CK and negative severe acute respiratory syndrome coronavirus 2. His clinical symptoms, including fatigue and muscle pain, had significantly improved. LESSONS: COVID-19 infection can cause muscle pain and fatigue, which can mask the symptoms of rhabdomyolysis. A missed diagnosis of rhabdomyolysis can be severe, especially in patients with ESRD. The serum CK level should be tested with clinical suspicion. Appropriate management, including adequate hydration and electrolyte balance, should be provided. Continuous renal replacement therapy should be considered in affected patients with renal insufficiency.
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spelling pubmed-106956082023-12-05 Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report Lu, Wenhui Li, Xiaoying You, Wenyi Gong, Rui Medicine (Baltimore) 4900 RATIONALE: Rhabdomyolysis can be an uncommon complication of coronavirus disease 2019 (COVID-19) infection. However, the diagnosis of rhabdomyolysis could be easily missed due to its atypical clinical presentations. We present a patient with a history of end-stage renal disease (ESRD) who contracted COVID-19 and subsequently developed rhabdomyolysis. We discuss and share our experience in the management of this patient. PATIENT CONCERNS: An 85-year-old male with ESRD undergoing routine hemodialysis was tested positive for COVID-19. The patient had clinical symptoms of fatigue, muscle pain, and difficulty walking. DIAGNOSIS: The serum creatine kinase (CK) level was markedly elevated to 32,492.9U/L, supporting the diagnosis of rhabdomyolysis. A computed tomography scan revealed muscle injuries throughout the body, confirming the diagnosis. INTERVENTIONS: The patient was managed through electrolyte corrections and continuous renal replacement therapy. OUTCOMES: Repeat tests showed decreased levels of serum CK and negative severe acute respiratory syndrome coronavirus 2. His clinical symptoms, including fatigue and muscle pain, had significantly improved. LESSONS: COVID-19 infection can cause muscle pain and fatigue, which can mask the symptoms of rhabdomyolysis. A missed diagnosis of rhabdomyolysis can be severe, especially in patients with ESRD. The serum CK level should be tested with clinical suspicion. Appropriate management, including adequate hydration and electrolyte balance, should be provided. Continuous renal replacement therapy should be considered in affected patients with renal insufficiency. Lippincott Williams & Wilkins 2023-12-01 /pmc/articles/PMC10695608/ http://dx.doi.org/10.1097/MD.0000000000036360 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle 4900
Lu, Wenhui
Li, Xiaoying
You, Wenyi
Gong, Rui
Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report
title Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report
title_full Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report
title_fullStr Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report
title_full_unstemmed Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report
title_short Rhabdomyolysis in a patient with end-stage renal disease and SARS-CoV-2 infection: A case report
title_sort rhabdomyolysis in a patient with end-stage renal disease and sars-cov-2 infection: a case report
topic 4900
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695608/
http://dx.doi.org/10.1097/MD.0000000000036360
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