Makaryus John N, Catanzaro John N, Katona Kyle C
North Shore University Hospital, Manhasset, NY11030, USA.
Hematology. 2007 Aug;12(4):349-52. doi: 10.1080/10245330701255254.
Based upon numerous reported cases and despite widespread beliefs to the contrary, sickle cell trait (SCT) may be deemed a quantifiable risk factor in certain subsets of patients. As a result of common misconceptions regarding SCT, most individuals with the condition are generally not informed regarding the possible consequences of certain activities such as venturing to high altitudes or participating in overly exertional physical activities. Acute exertional rhabdomyolysis is a potentially serious clinical illness and is caused by skeletal muscle injury resulting in the release of myoglobin and other cellular contents, including creatine kinase, into the circulatory system. Mild to moderate cases of acute exertional rhabdomyolysis can cause metabolic disorders including hypernatremia, hyperkalemia, hyperphosphatemia, hypocalcemia, lactic acidosis and hyperuricemia. Severe cases may result in renal failure and even death. Several case reports have been published since the early 1970s describing significant morbidity and mortality of acute exertional rhabdomyolysis in patients with SCT. We present the case of a 27-year-old male with a past medical history significant only for SCT who presented after a 1.5 mile run with severe exertional rhabdomyolysis and subsequent acute renal failure requiring hemodialysis (HD). In presenting this case, we hope to raise awareness of a possible underlying cause to many cases of exertional rhabdomyolysis and encourage physicians to counsel their patients with SCT in order to avoid the significant morbidity and mortality that may be associated with the condition.
基于众多已报道的病例，尽管存在普遍的相反观点，但镰状细胞性状（SCT）在某些患者亚组中可能被视为一种可量化的风险因素。由于对SCT存在常见的误解，大多数患有该病症的个体通常未被告知某些活动（如前往高海拔地区或参与过度劳累的体育活动）可能产生的后果。急性运动性横纹肌溶解症是一种潜在的严重临床疾病，由骨骼肌损伤导致肌红蛋白和其他细胞内容物（包括肌酸激酶）释放到循环系统中引起。轻度至中度的急性运动性横纹肌溶解症可导致代谢紊乱，包括高钠血症、高钾血症、高磷血症、低钙血症、乳酸酸中毒和高尿酸血症。严重病例可能导致肾衰竭甚至死亡。自20世纪70年代初以来，已有数篇病例报告发表，描述了SCT患者急性运动性横纹肌溶解症的显著发病率和死亡率。我们报告一例27岁男性病例，其既往病史仅为SCT，在进行1.5英里跑步后出现严重运动性横纹肌溶解症及随后的急性肾衰竭，需要进行血液透析（HD）。在呈现该病例时，我们希望提高对许多运动性横纹肌溶解症病例可能的潜在病因的认识，并鼓励医生向患有SCT的患者提供咨询，以避免可能与该病症相关的显著发病率和死亡率。
