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Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report
Patient: Male, 36 Final Diagnosis: Rhabdomyolysis induced acute renal failure Symptoms: Diarrhea • generalized weakness Medication: — Clinical Procedure: Hemodialysis • intubation Specialty: Critical Care Medicine OBJECTIVE: Unusual setting of medical care BACKGROUND: Rhabdomyolysis is a syndrome ca...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5507674/ https://www.ncbi.nlm.nih.gov/pubmed/28674380 http://dx.doi.org/10.12659/AJCR.905089 |
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author | Luckoor, Pavan Salehi, Mashal Kunadu, Afua |
author_facet | Luckoor, Pavan Salehi, Mashal Kunadu, Afua |
author_sort | Luckoor, Pavan |
collection | PubMed |
description | Patient: Male, 36 Final Diagnosis: Rhabdomyolysis induced acute renal failure Symptoms: Diarrhea • generalized weakness Medication: — Clinical Procedure: Hemodialysis • intubation Specialty: Critical Care Medicine OBJECTIVE: Unusual setting of medical care BACKGROUND: Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure. CASE REPORT: A 36-year-old African American male patient with no significant past medical history and a social history of cocaine and alcohol abuse presented with diarrhea and generalized weakness of 2 days’ duration. He was found to be febrile, tachycardic, tachypneic, and hypoxic. The patient was subsequently intubated and admitted to the medical ICU. Laboratory work-up showed acute renal failure with deranged liver functions test results, and elevated creatine kinase of 701,400 U/L. CK levels were subsequently too high for the lab to quantify. Urine legionella testing was positive for L. pneumophilia serogroup 1 antigen and urine toxicology was positive for cocaine. The patient had a protracted course in the ICU. He was initially started on CVVH, and later received intermittent hemodialysis for about 1 month. CONCLUSIONS: In the presence of multiple etiologic factors, rhabdomyolysis can be massive with resultant significant morbidity. Clinicians should have a high index of suspicion for rhabdomyolysis in the presence of multiple factors, as early recognition of this diseases is very important in the prevention and active management of life-threatening conditions. |
format | Online Article Text |
id | pubmed-5507674 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-55076742017-07-26 Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report Luckoor, Pavan Salehi, Mashal Kunadu, Afua Am J Case Rep Articles Patient: Male, 36 Final Diagnosis: Rhabdomyolysis induced acute renal failure Symptoms: Diarrhea • generalized weakness Medication: — Clinical Procedure: Hemodialysis • intubation Specialty: Critical Care Medicine OBJECTIVE: Unusual setting of medical care BACKGROUND: Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure. CASE REPORT: A 36-year-old African American male patient with no significant past medical history and a social history of cocaine and alcohol abuse presented with diarrhea and generalized weakness of 2 days’ duration. He was found to be febrile, tachycardic, tachypneic, and hypoxic. The patient was subsequently intubated and admitted to the medical ICU. Laboratory work-up showed acute renal failure with deranged liver functions test results, and elevated creatine kinase of 701,400 U/L. CK levels were subsequently too high for the lab to quantify. Urine legionella testing was positive for L. pneumophilia serogroup 1 antigen and urine toxicology was positive for cocaine. The patient had a protracted course in the ICU. He was initially started on CVVH, and later received intermittent hemodialysis for about 1 month. CONCLUSIONS: In the presence of multiple etiologic factors, rhabdomyolysis can be massive with resultant significant morbidity. Clinicians should have a high index of suspicion for rhabdomyolysis in the presence of multiple factors, as early recognition of this diseases is very important in the prevention and active management of life-threatening conditions. International Scientific Literature, Inc. 2017-07-04 /pmc/articles/PMC5507674/ /pubmed/28674380 http://dx.doi.org/10.12659/AJCR.905089 Text en © Am J Case Rep, 2017 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Articles Luckoor, Pavan Salehi, Mashal Kunadu, Afua Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report |
title | Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report |
title_full | Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report |
title_fullStr | Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report |
title_full_unstemmed | Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report |
title_short | Exceptionally High Creatine Kinase (CK) Levels in Multicausal and Complicated Rhabdomyolysis: A Case Report |
title_sort | exceptionally high creatine kinase (ck) levels in multicausal and complicated rhabdomyolysis: a case report |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5507674/ https://www.ncbi.nlm.nih.gov/pubmed/28674380 http://dx.doi.org/10.12659/AJCR.905089 |
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