Moghtader J, Brady W J, Bonadio W
Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, USA.
Pediatr Emerg Care. 1997 Dec;13(6):382-5. doi: 10.1097/00006565-199712000-00006.
Exertional rhabdomyolysis has been previously reported in adult patients following such strenuous activities as military basic training, weight lifting, and marathon running. Exertional rhabdomyolysis in previously healthy pediatric athletes, however, is rarely encountered. The presentation of rhabdomyolysis is characterized by the classical triad of myalgias, muscle weakness, and darkened urine. This classic presentation, however, is not noted the majority of patients, especially early in the disease course when the patient may complain only of myalgias or weakness. Thus, the emergency physician must have a high index of suspicion for this entity based on the appropriate clinical setting. We report a classic case of exercise-induced rhabdomyolysis complicated by acute renal failure in a previously healthy adolescent athlete, whose initial presentation was nonspecific, prompting the diagnosis of overexertion.
此前已有报道称，成年患者在经历军事基础训练、举重和马拉松跑步等剧烈活动后会发生运动性横纹肌溶解症。然而，此前健康的儿科运动员发生运动性横纹肌溶解症的情况却很少见。横纹肌溶解症的表现特征为肌痛、肌肉无力和尿液颜色加深这一经典三联征。然而，大多数患者并未出现这种典型表现，尤其是在疾病早期，此时患者可能仅主诉肌痛或无力。因此，急诊医生必须根据适当的临床情况，对该病症保持高度怀疑。我们报告了一例典型的运动诱发横纹肌溶解症合并急性肾衰竭的病例，患者为一名此前健康的青少年运动员，其最初表现不具有特异性，最初被诊断为过度劳累。
