Vietnamese
Albanian
Arabic
Armenian
Azerbaijani
Belarusian
Bengali
Bosnian
Catalan
Czech
Danish
Deutsch
Dutch
English
Estonian
Finnish
Français
Greek
Haitian Creole
Hebrew
Hindi
Hungarian
Icelandic
Indonesian
Irish
Italian
Japanese
Korean
Latvian
Lithuanian
Macedonian
Mongolian
Norwegian
Persian
Polish
Portuguese
Romanian
Russian
Serbian
Slovak
Slovenian
Spanish
Swahili
Swedish
Turkish
Ukrainian
Vietnamese
Български
中文(简体)
中文(繁體)
Acta Medica Croatica 2008-Jul

[Acute rhabdomyolysis: a case report and literature review].

Chỉ người dùng đã đăng ký mới có thể dịch các bài báo
Đăng nhập Đăng ký
Liên kết được lưu vào khay nhớ tạm
Viviana Mrsić
Visnja Nesek Adam
Elvira Grizelj Stojcić
Zarko Rasić
Aleksandra Smiljanić
Ivica Turcić

Từ khóa

trừu tượng

Acute rhabdomyolysis is a syndrome characterized by the lesion of skeletal muscle resulting in subsequent release of intracellular contents into the circulatory system, which can cause potentially lethal complications. These contents include myoglobin, creatine phosphokinase, potassium, aldolase, lactate dehydrogenase and glutamic-oxaloacetic transaminase. There are numerous causes that can lead to acute rhabdomyolysis and many of patients present with multiple causes. The most common potentially lethal complication of rhabdomyoloysis is acute renal failure. In this article we present a case of a patient that developed clinical signs of acute rhabdomyolysis after consumption of heroin and alcohol. After approximately nine hours of alcohol and heroin induced coma he had acute compartment syndrome of the right arm, and clinical and laboratory signs of acute rhabdomyolysis with acute renal failure as a complication of rhabdomyolysis. Acute rhabdomyolysis developed in the patient as the result of acute compartment syndrome, with direct toxic activity of alcohol and diamorphine. During the period of coma, due to lying in particular position over a long period of time, pressure upon the certain part of the body caused muscle compression and capillary occlusion in fascial compartments, which led to ischemia. Upon pressure relief and beginning of tissue recovery, post ischemic compartment syndrome occurred with subsequent rhabdomyolysis. Getting out of coma the patient started to complain of severe pain in the right arm, which clinically worsened on passive stretching of the limb, with the loss of sensation and weakness. Laboratory findings showed high levels of creatine phosphokinase as the most sensitive marker of muscular damage. The peak of creatine phosphokinase level can be predictive for the development of acute renal failure because myoglobin level may return to normal within 6 hours after muscle injury. The peak of creatine phosphokinase (186.080 U/L; normal range 0-177) was recorded at 12 hours of admission. Other pertinent laboratory results such as urea, creatinine, prothrombin time, alanine aminotransferase and aspartate aminotransferase were also changed significantly. The peak of potassium level before dialysis was 6.8 mmol/L. Emergency fasciotomy of the anterior and posterior compartment syndrome was performed by a team of physicians after clinical examination. The second look debridement was performed at 48 and 72 hours. The plastic surgical procedure was performed 4 weeks later. On admission the patient also had oliguria with dark brown pigment in his urine. Arterial blood gases revealed metabolic and respiratory acidosis. The patient was hypovolemic and IV rehydratation with crystalloids, sodium bicarbonate and mannitol started immediately upon admission. Despite therapy his urine output decreased. Hemodialysis was initiated at serum potassium level of 6.8 mm/L and continued until his urine output returned to normal in three weeks. The patient was discharged from the hospital after six weeks, with normal urine output, without functional abnormality in his upper right limb. Acute rhabdomyolysis should be considered as a possibility in any patient with prolonged imobilization while in coma as well as in any intoxicated patient. Of course, creatine phosphokinase is the most sensitive indicator of muscle injury and the degree of creatine phosphokinase elevation correlates with the amount of muscle injury and disease severity. Other laboratory findings can help identify common complications of rhabdomyolysis such as acute renal failure, metabolic derangements and disseminated intravascular coagulopathy.

Tham gia trang
facebook của chúng tôi

Cơ sở dữ liệu đầy đủ nhất về dược liệu được hỗ trợ bởi khoa học

  • Hoạt động bằng 55 ngôn ngữ
  • Phương pháp chữa bệnh bằng thảo dược được hỗ trợ bởi khoa học
  • Nhận dạng các loại thảo mộc bằng hình ảnh
  • Bản đồ GPS tương tác - gắn thẻ các loại thảo mộc vào vị trí (sắp ra mắt)
  • Đọc các ấn phẩm khoa học liên quan đến tìm kiếm của bạn
  • Tìm kiếm dược liệu theo tác dụng của chúng
  • Sắp xếp sở thích của bạn và cập nhật các nghiên cứu tin tức, thử nghiệm lâm sàng và bằng sáng chế

Nhập một triệu chứng hoặc một căn bệnh và đọc về các loại thảo mộc có thể hữu ích, nhập một loại thảo mộc và xem các bệnh và triệu chứng mà nó được sử dụng để chống lại.
* Tất cả thông tin dựa trên nghiên cứu khoa học đã được công bố

Google Play badgeApp Store badge