Amin Toka, Nassar Mahmoud, Abosheaishaa Hazem, Ali Amr, Zirkiyeva Milana, Lopez Ricardo
Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.
Gastroenterology, Cairo University, Cairo, EGY.
Cureus. 2023 Apr 24;15(4):e38042. doi: 10.7759/cureus.38042. eCollection 2023 Apr.
We present a patient who presented with diabetic ketoacidosis and severe rhabdomyolysis-induced acute kidney injury. The patient developed generalized edema, nausea, and vomiting, and his kidney function deteriorated, necessitating renal replacement therapy, despite the successful treatment of his initial conditions. A comprehensive evaluation was conducted to determine the underlying cause of the severe rhabdomyolysis, including autoimmune myopathies, viral infections, and metabolic disorders. A muscle biopsy revealed necrosis and myophagocytosis but no significant inflammation or myositis. The patient's clinical and laboratory results improved with appropriate treatment, including temporary dialysis and erythropoietin therapy, and he was discharged to continue his rehabilitation with home health care.
我们报告了一名患有糖尿病酮症酸中毒和严重横纹肌溶解症所致急性肾损伤的患者。尽管其初始病情得到成功治疗,但该患者仍出现全身水肿、恶心和呕吐,且肾功能恶化,需要进行肾脏替代治疗。我们进行了全面评估以确定严重横纹肌溶解症的潜在病因,包括自身免疫性肌病、病毒感染和代谢紊乱。肌肉活检显示有坏死和肌吞噬现象,但无明显炎症或肌炎。通过适当治疗,包括临时透析和促红细胞生成素治疗,患者的临床和实验室检查结果有所改善,随后出院并接受家庭医疗保健以继续康复。