Samuel Hanock Unni, Balasubramaniyan T, Thirumavalavan S, Vasudevan C, Senthil Kumar R P, Murugesan V, Abraham Anila
Department of Nephrology, Government Kilpauk Medical College, Chennai, Tamil Nadu, India.
Renopath, Center for Renal and Urological Pathology, Chennai, Tamil Nadu, India.
Indian J Pathol Microbiol. 2021 Apr-Jun;64(2):382-384. doi: 10.4103/IJPM.IJPM_89_20.
Rhabdomyolysis is a potentially life-threatening clinical syndrome characterized by the breakdown of skeletal muscle cells and release of creatine kinase (CK), lactate dehydrogenase (LDH), and myoglobin into the plasma and interstitial space. Rhabdomyolysis can occur due to a variety of causes and acute kidney injury (AKI) is one of its most dreaded complications occurring in 33%-50% patients. The main pathophysiology of renal injury is due to vasoconstriction, intraluminal casts, tubular obstruction, and direct myoglobin toxicity. As the symptoms are nonspecific, a high level of suspicion is required in the mind of the treating physician. Early diagnosis and prompt management with fluid resuscitation, initiation of renal replacement therapy (RRT), and elimination of causative agents can help prevent complications. We hereby report four interesting cases of this clinical syndrome with emphasis on the causative agents.
横纹肌溶解症是一种潜在的危及生命的临床综合征，其特征是骨骼肌细胞分解，肌酸激酶（CK）、乳酸脱氢酶（LDH）和肌红蛋白释放到血浆和间质间隙中。横纹肌溶解症可由多种原因引起，急性肾损伤（AKI）是其最可怕的并发症之一，发生在33%-50%的患者中。肾损伤的主要病理生理学原因是血管收缩、管腔内管型形成、肾小管阻塞以及肌红蛋白的直接毒性作用。由于症状不具有特异性，治疗医生必须高度怀疑。早期诊断并通过液体复苏、启动肾脏替代治疗（RRT）以及消除致病因素进行及时处理，有助于预防并发症。我们在此报告该临床综合征的四个有趣病例，并重点关注致病因素。
