Muto S, Tabei K, Asano Y, Hosoda S
Jpn J Med. 1987 Feb;26(1):76-80. doi: 10.2169/internalmedicine1962.26.76.
Rhabdomyolysis can be induced by a variety of physical and chemical insults to skeletal muscle. Though there are only a few reports of myositis associated with viral diseases, and no reported cases of virus-induced rhabdomyolysis in uremic patients. Chronic uremic states have been known to potentiate a variety of metabolic and immunological abnormalities. Present case had an acute, progressive and fatal rhabdomyolysis which was thought to be induced by virus infection. A 43-year-old man had received hemodialysis therapy for 8 years. He suffered from an upper respiratory tract infection 11 days before admission. On admission, he was diagnosed as rhabdomyolysis with severe lactic acidosis and marked hyperkalemia. Although intensive care had been performed, he died of uncontrollable hyperkalemia (10.0 mEq/L) 2 days after admission. Maximum CPK and GOT levels were 105,200 and 56,800 mU/ml, respectively. Most probable cause of rhabdomyolysis was thought to be Parainfluenza type-3 infection, though histological examination failed to prove virus infection.
横纹肌溶解症可由多种对骨骼肌的物理和化学损伤诱发。虽然仅有少数关于病毒感染相关肌炎的报道，且尚无尿毒症患者病毒诱导的横纹肌溶解症病例报告。已知慢性尿毒症状态会加剧多种代谢和免疫异常。本病例出现了急性、进行性且致命的横纹肌溶解症，据认为是由病毒感染诱发的。一名43岁男性接受血液透析治疗8年。入院前11天，他患上呼吸道感染。入院时，他被诊断为横纹肌溶解症，伴有严重乳酸酸中毒和显著高钾血症。尽管进行了重症监护，但他在入院2天后死于无法控制的高钾血症（10.0毫当量/升）。肌酸磷酸激酶（CPK）和谷草转氨酶（GOT）的最高水平分别为105200和56800毫国际单位/毫升。横纹肌溶解症最可能的病因被认为是3型副流感病毒感染，尽管组织学检查未能证实病毒感染。
