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一名24岁健康女性的严重运动性横纹肌溶解症:病例报告及文献综述

Severe Exertional Rhabdomyolysis in a Healthy 24-Year-Old Woman: A Case Report and Review of Literature.

作者信息

Willard Jonathan, Green Kelsey, Tsega Tenaadam, Bathi Srilekha, Michael Miriam B, Deonarine Anand

机构信息

Internal Medicine, Howard University Hospital, Washington, DC, USA.

Internal Medicine, University of Maryland, Baltimore, USA.

出版信息

Cureus. 2024 Nov 12;16(11):e73545. doi: 10.7759/cureus.73545. eCollection 2024 Nov.

DOI:10.7759/cureus.73545
PMID:39677125
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11638380/
Abstract

Rhabdomyolysis is characterized by the release of muscle cell components into circulation following muscle cell injury. Common causes include trauma and compression, exposure to drugs and toxins, and intense physical exercise. This study depicts a case of exercise-induced rhabdomyolysis following a cycling class. A 24-year-old African American woman presented to the emergency department with a one-day history of bilateral lower extremity myalgia, weakness, and stiffness, predominantly on the right side. She had participated in a one-hour morning cycling exercise class the previous day and came to the emergency department the following morning after noting dark-colored urine. Her initial creatine phosphokinase (CPK) level was 53,601 IU/L, leading to a diagnosis of exertional rhabdomyolysis. Her CPK continued to rise, peaking at 175,294 IU/L approximately 34 hours after admission. Serum chemistry, liver function, and clinical complications were closely monitored during the patient's hospitalization. The patient responded well to IV fluids, showed clinical improvement, and did not require additional interventions or specialist consultations. Exertional rhabdomyolysis is increasingly common following exercise and may lead to serious complications. Prognosis in rhabdomyolysis is best when treated early and aggressively.

摘要

横纹肌溶解症的特征是肌肉细胞损伤后,肌肉细胞成分释放到血液循环中。常见原因包括创伤和挤压、接触药物和毒素以及剧烈体育锻炼。本研究描述了一例骑行课后运动诱发的横纹肌溶解症病例。一名24岁的非裔美国女性因双侧下肢肌痛、无力和僵硬(主要在右侧)一天的病史就诊于急诊科。她前一天参加了一小时的晨骑运动课程,第二天早上发现尿液颜色变深后前往急诊科。她最初的肌酸磷酸激酶(CPK)水平为53,601 IU/L,诊断为运动性横纹肌溶解症。她的CPK持续升高,入院后约34小时达到峰值175,294 IU/L。在患者住院期间密切监测血清化学、肝功能和临床并发症。患者对静脉输液反应良好,临床症状改善,无需额外干预或专科会诊。运动性横纹肌溶解症在运动后越来越常见,可能会导致严重并发症。横纹肌溶解症早期积极治疗预后最佳。

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