Carrillo-Esper Raúl, Ornelas-Arroyo Sofía, Pérez-Bustos Estela, Sánchez-Zúñiga Jesús, Uribe-Esquivel Misael
Fundación Clínica Médica Sur, México D.F., México.
Gac Med Mex. 2009 Nov-Dec;145(6):519-21.
Rabdomiolysis and acute renal failure secondary to influenza infection are rare. Up to now, few cases have been reported and most of them are primarily among children. Myositis associated to influenza infection is caused by the toxic effect of the virus in the muscular fiber, dysregulation of inflammatory cytokines and a cross reaction between the muscle fiber and the viral particles. We present the case of a 57 year old male with a diagnosis of H1N1 influenza who developed polyuria, oligoanuria, elevation of lactic dehydrogenase, myoglobin, creatinin phosphokinase and an electromyography with a myopathic pattern. The diagnosis of rabdomyolisis and acute renal failure were made, hemodyalisis was started and the patient improved satisfactorily. This is the first report of a patient with radmoyolisis and acute renal failure secondary to A H1N1 influenza treated during the Mexico epidemic.
流感感染继发横纹肌溶解症和急性肾衰竭较为罕见。截至目前,仅有少数病例报道,且大多数病例主要发生在儿童中。与流感感染相关的肌炎是由病毒对肌纤维的毒性作用、炎性细胞因子失调以及肌纤维与病毒颗粒之间的交叉反应引起的。我们报告一例57岁男性,诊断为H1N1流感,出现多尿、少尿、乳酸脱氢酶、肌红蛋白、肌酸磷酸激酶升高以及肌电图呈肌病模式。诊断为横纹肌溶解症和急性肾衰竭,开始进行血液透析,患者病情得到满意改善。这是墨西哥疫情期间首例继发于甲型H1N1流感的横纹肌溶解症和急性肾衰竭患者的报告。