Khan Zahid, Ahmed Osman, Muhammad Syed Aun, Carpio Jonard
Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.
Cardiology, Barts Heart Centre, London, GBR.
Cureus. 2024 Jan 20;16(1):e52625. doi: 10.7759/cureus.52625. eCollection 2024 Jan.
Rhabdomyolysis is a syndrome caused by skeletal muscle disruption that results in the release of muscle proteins into circulation, which can lead to life-threatening systemic complications. These complications include acute kidney injury (AKI), renal failure, compartment syndrome, and disseminated intravascular coagulopathy. Patients commonly present with muscle pain, fatigue, weakness, and dark-colored urine. We present the case of a 37-year-old male who presented to the hospital with pain in the lower limbs and difficulty in mobility for the past two days after returning from Jamaica. He had a mild cold and body aches but denied any sore throat, cough, or shortness of breath (SOB). He tested negative for COVID-19. He had attended his local hospital the previous night, but due to the long waiting time, he presented to the accident and emergency department at our hospital. His physical examination was normal, and his urine was dark in color. All laboratory test results were normal, except for creatinine kinase (CK) levels >100,000 IU/L (reference: 40-320 IU/L) and an alanine transaminase (ALT) level of 376 U/L (reference: 30-130 U/L). Magnetic resonance imaging of both femurs revealed a high signal in multiple muscle compartments bilaterally on a short TI inversion recovery (STIR) sequence. Autoimmune screening results were negative. He had a similar episode last year due to COVID-19 with elevated CK levels. He received conservative treatment with IV fluids and was discharged eight days after hospital admission.
横纹肌溶解症是一种由骨骼肌破坏引起的综合征,可导致肌肉蛋白释放到循环系统中,进而引发危及生命的全身并发症。这些并发症包括急性肾损伤(AKI)、肾衰竭、骨筋膜室综合征和弥散性血管内凝血。患者通常表现为肌肉疼痛、疲劳、无力和深色尿液。我们报告一例37岁男性病例,该患者从牙买加返回后,在过去两天出现下肢疼痛和活动困难。他有轻度感冒和全身疼痛,但否认有任何喉咙痛、咳嗽或呼吸急促(SOB)。他的新冠病毒检测呈阴性。他前一晚去过当地医院,但由于等待时间过长,便来到我们医院的急诊科。他的体格检查正常,尿液颜色较深。除肌酸激酶(CK)水平>100,000 IU/L(参考值:40 - 320 IU/L)和丙氨酸转氨酶(ALT)水平376 U/L(参考值:30 - 130 U/L)外,所有实验室检查结果均正常。双侧股骨的磁共振成像显示,在短TI反转恢复(STIR)序列上,双侧多个肌肉间隙出现高信号。自身免疫筛查结果为阴性。他去年因新冠病毒感染也有过类似发作,当时CK水平升高。他接受了静脉输液的保守治疗,入院八天后出院。