Ishiwada Naruhiko, Takada Nobuyuki, Okunushi Tomoko, Hishiki Haruka, Katano Harutaka, Nakajima Noriko, Kohno Yoichi
Department of Pediatrics, Chiba University Hospital, Chiba, Japan.
Pediatr Int. 2012 Oct;54(5):703-5. doi: 10.1111/j.1442-200X.2012.03571.x.
The influenza A/H1N1 2009 epidemic has spread to many countries since 2009, including Japan. We report an immune-competent child involving rhabdomyolysis and compartment syndrome associated with influenza A/H1N1 2009. The patient was demonstrated rhabdomyolysis with myoglobinuria, hyperkalemia, cardiac dysfunction and compartment syndrome that arose during convalescence from influenza A/H1N1 2009 infection. Although RT-PCR of muscle tissue yielded negative results for influenza A/H1N1 2009 RNA and no viral positive-antigen cells were detected in the muscle lesions, the clinical picture suggested rhabdomyolysis associated with influenza A/H1N1. Rhabdomyolysis should be considered in the evaluation of muscle symptoms such as myalgia associated with novel influenza A/H1N1 2009 virus infection, particularly in critically ill patients.
自2009年以来，甲型H1N1流感疫情已蔓延至包括日本在内的许多国家。我们报告了一例免疫功能正常的儿童，其出现横纹肌溶解和骨筋膜室综合征，与2009年甲型H1N1流感有关。该患者在2009年甲型H1N1流感感染恢复期出现横纹肌溶解伴肌红蛋白尿、高钾血症、心脏功能障碍和骨筋膜室综合征。尽管肌肉组织的逆转录聚合酶链反应（RT-PCR）检测甲型H1N1流感病毒RNA结果为阴性，且在肌肉病变中未检测到病毒阳性抗原细胞，但临床表现提示横纹肌溶解与甲型H1N1流感有关。在评估与2009年新型甲型H1N1流感病毒感染相关的肌肉症状（如肌痛）时，应考虑横纹肌溶解，尤其是在重症患者中。
