The clinical characteristics of rhabdomyolysis in patients with liver cirrhosis.

BACKGROUND

We have frequently seen idiopathic rhabdomyolysis developed after liver cirrhosis (LC) in our hospital. This has rarely been reported, and no studies have compared it with other cases of rhabdomyolysis.

GOALS

We attempted to examine the pathologic characteristics of rhabdomyolysis development and to assess the prognosis in patients with LC.

STUDY

We retrospectively reviewed the medical records of 243 patients (261 cases) with rhabdomyolysis and selected 74 patients (91 cases) for the study group, who concurrently had LC. Seventy-five patients (76 cases) with no evidence of LC were served as controls.

RESULTS

In 59.3% of the LC-group patients, the causes of rhabdomyolysis were not identified. In 10.5% of the control-group patients, the causes of rhabdomyolysis proved to be unknown (P=0.000). In 17.6% of the LC-group patients, 30 cases (33.0%) of the recurrent rhabdomyolysis were identified. In the control group, only one case of the recurrent rhabdomyolysis was noted (P=0.001). The mortality was significantly higher in the LC group than the control group (27.5% vs. 14.5%) (P=0.042). Of 25 LC-group patients who died, 96.0% had Child-Pugh classification C. In addition, 84.0% developed acute renal failure during the course. Coexistent infection, hepatic encephalopathy, and the elevated levels of serum lactate dehydrogenase and C-reactive protein were also important prognostic factors.

CONCLUSIONS

In conclusion, rhabdomyolysis is developed without specific causes in patients with LC, and it is serious and often fatal particularly in cases in which acute renal failure and severe hepatic dysfunction exist. Our results indicate that LC is the underlying disease for the development of rhabdomyolysis.