Stahl Christine E, Borlongan Cesar V, Szerlip Molly, Szerlip Harold
Department of Internal Medicine, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA 30905, USA.
Med Sci Monit. 2006 Sep;12(9):CS81-4.
We describe a rare case of severe rhabdomyolysis provoked by ingestion of a performance-enhancer herbal supplement containing ephedra.
A healthy 21-year-old Army soldier complained of "complete muscle failure" after collapsing at the end of Army Physical Fitness Test. The patient was found to be tachycardic and hypotensive, but his vital signs quickly stabilized after receiving sodium chloride in the ambulance. Physical examination of the patient, including a thorough neuromuscular exam, was unremarkable. Urine tested positive for myoglobin. Initial creatinine kinase was 426 U/L, which increased to a maximum creatinine kinase of 241,418 ti/IL by hospital day 6. The patient also developed acute renal failure secondary to pigment-induced actute tubular necrosis. He was treated with bicarbonate-containing fluid. The patient's creatinine kinase and renal function had normalized at one month follow-up. A muscle biopsy was negative for underlying neuromuscular disease. His past medical history was only notable for the patient having taken 2 tablets of an herbal supplement containing ephedra every day for a month leading to his physical fitness test.
Rhabdomvolvsis and myoglobinuric renal failure associated with ephedra use are a very uncommion occurrence, but a significant clinical event that should be closely monitored due to rampant use by young adults of ephedra-containing dietary supplements.
我们描述了一例罕见的严重横纹肌溶解症，由摄入含有麻黄的增强体能的草药补充剂引发。
一名健康的21岁陆军士兵在陆军体能测试结束时晕倒后，抱怨“完全肌肉无力”。患者被发现心动过速和血压过低，但在救护车上接受氯化钠治疗后，其生命体征迅速稳定。对患者的体格检查，包括全面的神经肌肉检查，均无异常。尿液肌红蛋白检测呈阳性。初始肌酸激酶为426 U/L，到住院第6天时，肌酸激酶最高升至241,418 U/L。患者还因色素诱导的急性肾小管坏死继发急性肾衰竭。他接受了含碳酸氢盐的液体治疗。在1个月的随访中，患者的肌酸激酶和肾功能恢复正常。肌肉活检未发现潜在的神经肌肉疾病。他的既往病史仅显示在体能测试前一个月，患者每天服用2片含麻黄的草药补充剂。
与使用麻黄相关的横纹肌溶解症和肌红蛋白尿性肾衰竭非常罕见，但由于年轻人大量使用含麻黄的膳食补充剂，这是一个应密切监测的重大临床事件。
