Moriarty Natassja, Moriarty Jonathan, Keating John
Department of Medicine, Furness General Hospital, Barrow-in-Furness, UK.
Department of Gastroenterology, Furness General Hospital, Barrow-in-Furness, UK.
Eur J Case Rep Intern Med. 2020 May 29;7(8):001704. doi: 10.12890/2020_001704. eCollection 2020.
We present a patient with pancreatic cancer who developed weakness, acute renal failure and significantly raised creatine kinase levels post-ERCP and who was assessed as having contrast-induced rhabdomyolysis.
The patient underwent haemofiltration and ultimately succumbed to his condition.
Rhabdomyolysis is a potentially life-threatening condition which occurs because of damage to skeletal muscle, with release of myoglobin and electrolytes into the circulation. The mortality rate is 59% in severe cases, despite appropriate treatment.
Iodine-based contrast can cause rhabdomyolysis by reducing blood flow to the muscle.Renal replacement therapy does not improve the mortality rate of rhabdomyolysis.<10% of patients present with the classic triad of myalgia, muscle weakness and tea-coloured urine; creatine kinase levels greater than 5 times the upper limit of normal are the gold standard for diagnosing rhabdomyolysis that is not related to statin use.
我们报告一例胰腺癌患者，其在接受内镜逆行胰胆管造影（ERCP）后出现乏力、急性肾衰竭，肌酸激酶水平显著升高，经评估诊断为造影剂诱导的横纹肌溶解症。
该患者接受了血液滤过治疗，但最终病情恶化死亡。
横纹肌溶解症是一种潜在的危及生命的疾病，由于骨骼肌受损，肌红蛋白和电解质释放进入循环系统所致。尽管进行了适当治疗，严重病例的死亡率仍为59%。
碘造影剂可通过减少肌肉血流导致横纹肌溶解症。肾脏替代治疗并不能提高横纹肌溶解症的死亡率。不到10%的患者出现肌痛、肌无力和茶色尿这一典型三联征；肌酸激酶水平高于正常上限5倍是诊断与他汀类药物使用无关的横纹肌溶解症的金标准。
