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轻度 2019 冠状病毒病合并β-地中海贫血患者的横纹肌溶解症。

Rhabdomyolysis in a Case of Mild Coronavirus Disease 2019 and β-Thalassemia Minor.

机构信息

Postgraduate Resident, Department of Internal Medicine, Manipal Hospitals, Bengaluru, Karnataka, India, Corresponding Author.

Consultant, Department of Infectious Diseases, Manipal Hospitals, Bengaluru, Karnataka, India.

出版信息

J Assoc Physicians India. 2024 Sep;72(9):97-99. doi: 10.59556/japi.72.0612.

Abstract

The novel coronavirus disease 2019 (COVID-19) virus primarily causes respiratory disease. Musculoskeletal manifestations are frequent, but rhabdomyolysis is a rare complication of COVID-19. It can be easily missed when there is a lack of high suspicion, especially in mild cases. Serum creatine phosphokinase (CPK) is a simple and affordable test that can screen COVID-19 patients having rhabdomyolysis, especially when they have predominant musculoskeletal symptoms. Early recognition and management of rhabdomyolysis can prevent acute kidney injury (AKI) and its related complications. Here, we present a young male with β-thalassemia minor who had tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on reverse transcription polymerase chain reaction (RT-PCR). He presented with symptoms suggestive of upper respiratory tract infection and myalgia. He later complained of cola-colored urine. Urine evaluation did not reveal myoglobinuria or hematuria, and there was no evidence of significant hemolysis. Extremely high serum CPK levels and the clinical scenario were suggestive of rhabdomyolysis. He was admitted and adequately hydrated with other symptomatic management. His renal functions and other parameters were monitored. He recovered well with an uneventful course in the hospital.

摘要

2019 年新型冠状病毒病(COVID-19)病毒主要引起呼吸道疾病。肌肉骨骼表现频繁,但横纹肌溶解症是 COVID-19 的罕见并发症。当缺乏高度怀疑时,很容易被忽视,尤其是在轻症病例中。血清肌酸磷酸激酶(CPK)是一种简单且经济实惠的检测方法,可以筛查 COVID-19 患者是否患有横纹肌溶解症,特别是当他们主要出现肌肉骨骼症状时。早期识别和治疗横纹肌溶解症可以预防急性肾损伤(AKI)及其相关并发症。在这里,我们介绍了一名年轻男性,他患有β-地中海贫血小细胞低色素性贫血,经逆转录聚合酶链反应(RT-PCR)检测对严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)呈阳性。他出现了上呼吸道感染和肌肉疼痛的症状。后来他抱怨尿液呈可乐色。尿液评估未发现肌红蛋白尿或血尿,也没有明显溶血的证据。极高的血清 CPK 水平和临床情况提示横纹肌溶解症。他被收治入院,接受充分水化和其他对症治疗。他的肾功能和其他参数得到了监测。他在医院恢复良好,无并发症。

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