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一名患有麦克尔氏病的个体在进行低强度有氧运动后发生横纹肌溶解症。

Rhabdomyolysis Episode in an Individual with McArdle's Disease after Low Aerobic Exercise.

作者信息

Dantas Guilherme Henrique Mattos, Oliveira Artur Luís Bessa de, Marcos-Pardo Pablo Jorge, Coutinho Vanessa Franco Ferreira, Sá Freire Felipe Cassau de, Castro Juliana Brandão Pinto de, Souza Vale Rodrigo Gomes de

机构信息

Department of Physical Activity Sciences (DCAF), Laboratory of Exercise and Sport (LABEES); Postgraduate Program in Exercise and Sport Sciences, Institute of Physical Education and Sports, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Physical Education College, Federal University of Mato Grosso, Cuiabá, Brazil.

出版信息

Saudi J Kidney Dis Transpl. 2022 Feb;33(Supplement):S91-S99. doi: 10.4103/1319-2442.374387.

Abstract

McArdle's disease, known as blockage of muscle glycogen metabolism, is characterized by glycogen accumulation of chains in skeletal striated muscles. One of the typical symptoms of the disease is the feeling of intolerance to exercise. Severe muscle cram and contracture, which often cause stiffness, occur due to a lack of muscle energy substrate during the exercise. These factors can lead to muscle damage, myoglobinuria, and, in severe cases, renal failure and rhabdomyolysis. Rhabdomyolysis is a syndrome that presents injury and necrosis of muscle cells leading to the release of intracellular material to the circulatory system. The present study aimed to report rhabdomyolysis in an individual with McArdle's disease after exercise of walking with low intensity. Patient, aged 33 years, was treated in the emergency room of a hospital located in the State of Rio de Janeiro, Brazil. After performing a full lap on the block of home (500 m in ~4 min 37 s), walking at a moderate speed (6.5 km/h), the individual felt sick and was rescued, later being hospitalized. The examinations collected presented hematocrit (HCT) compatible with chronic disease anemia and myoglobinuria. The patient was discharged from the intensive care center on the 3 day, after a 45% drop in creatine kinase. The patient described in the present study achieved full recovery. Attention to symptoms, early diagnosis, and immediate treatment made it possible to interrupt the development of complications caused by rhabdomyolysis, not allowing progression to acute renal failure.

摘要

麦克尔迪氏病,即肌肉糖原代谢受阻,其特征是骨骼肌中糖原链的积累。该疾病的典型症状之一是运动不耐受感。运动期间由于缺乏肌肉能量底物,会出现严重的肌肉痉挛和挛缩,常导致僵硬。这些因素可导致肌肉损伤、肌红蛋白尿,严重时可导致肾衰竭和横纹肌溶解。横纹肌溶解是一种综合征,表现为肌肉细胞损伤和坏死,导致细胞内物质释放到循环系统中。本研究旨在报告一名患有麦克尔迪氏病的个体在进行低强度步行运动后发生横纹肌溶解的情况。患者为33岁,在巴西里约热内卢州一家医院的急诊室接受治疗。在以中等速度(约6.5公里/小时)在家附近街区走了一整圈(约500米,用时约4分37秒)后,该个体感到不适并被急救,随后住院。所收集的检查结果显示血细胞比容(HCT)与慢性病贫血相符且存在肌红蛋白尿。肌酸激酶下降45%后,患者在第3天从重症监护中心出院。本研究中描述的患者实现了完全康复。对症状的关注、早期诊断和及时治疗使得有可能中断横纹肌溶解引起的并发症的发展,避免进展为急性肾衰竭。

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