新冠病毒感染后缓慢进展性横纹肌溶解症：肌酸激酶与肌红蛋白升高不一致时对急性肾损伤预测的启示

Slowly Progressive Rhabdomyolysis Post COVID-19: Insights for Acute Kidney Injury Prediction With Discordant Creatine Kinase and Myoglobin Elevations.

作者信息

Okubo Takeshi, Kouzu Hidemichi, Kamada Ayaka, Endo Kota, Kawaharata Wataru, Ohwada Wataru, Suda Kentaro, Nagano Nobutaka, Sakurai Ayami, Koyama Masayuki, Furuhashi Masato

机构信息

Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, JPN.

Department of Clinical Genetics, Sapporo Medical University Hospital, Sapporo, JPN.

出版信息

Cureus. 2024 Aug 29;16(8):e68145. doi: 10.7759/cureus.68145. eCollection 2024 Aug.

DOI:10.7759/cureus.68145

PMID:39347295

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11438541/

Abstract

Rhabdomyolysis can lead to acute kidney injury (AKI), primarily due to myoglobin-induced tubular damage. We present a case of slowly progressive rhabdomyolysis following SARS-CoV-2 infection in a 28-year-old male who was monitored through serial serum creatine kinase (CK) and myoglobin levels. Despite prominent CK elevations, the patient did not develop AKI, probably due to disproportionately mild serum myoglobin elevation with distinctive cyclic spikes. This case underscores the informative value of frequent monitoring of both CK and myoglobin to assess muscle damage severity and AKI risk in rhabdomyolysis, particularly with viral infections like COVID-19 that can cause delayed-onset muscle injury.

摘要

横纹肌溶解症可导致急性肾损伤（AKI），主要是由于肌红蛋白引起的肾小管损伤。我们报告一例28岁男性感染新型冠状病毒2后出现的缓慢进展性横纹肌溶解症病例，通过连续监测血清肌酸激酶（CK）和肌红蛋白水平对其进行观察。尽管CK显著升高，但该患者未发生AKI，这可能是由于血清肌红蛋白升高程度相对较轻且有独特的周期性峰值。该病例强调了频繁监测CK和肌红蛋白对于评估横纹肌溶解症中肌肉损伤严重程度和AKI风险的参考价值，尤其是对于像COVID-19这种可导致延迟性肌肉损伤的病毒感染。