Alcohol abuse-related severe acute pancreatitis with rhabdomyolysis complications

Abstract

Abstract. Non-traumatic rhabdomyolysis is a rare complication of acute pancreatitis. One of the major risk factors of both acute pancreatitis and rhabdomyolysis is alcohol abuse. However, only a few studies have reported the prognosis and association of severe acute pancreatitis (SAP) and rhabdomyolysis in alcohol abuse patients. In the present study, we report two cases presenting with SAP complicated by rhabdomyolysis following high-dose alcohol intake. The disease onset, clinical manifestations, laboratory data, diagnosis and treatment procedure of each patient were recorded, and the association with rhabdomyolysis was analyzed. Alcohol consumption was the most predominant cause of SAP and rhabdomyolysis in these patients. SAP-related rhabdomyolysis was primarily induced by the toxicity associated with pancreatic necrosis. The laboratory tests revealed that the concentration of serum creatine kinase (CK) and myoglobin increased and acute renal failure symptoms were present, which provided an exact diagnosis for SAP-induced rhabdomyolysis. Rhabdomyolysis and subsequent hypermyoglobinuria severely impaired kidney function and aggravated hypocalcemia. The therapy of early stage SAP complicated by rhabdomyolysis involved liquid resuscitation support. When first stage treatment fails, blood purification should be performed immediately. Both patients developed multiple organ failure (MOF) and succumbed to the disease. Considering the two cases presented, we conclude that alcohol-related SAP complicated by rhabdomyolysis may have a poor clinical prognosis.

Diagnostic Potential of Ratio Between Creatine Kinase and Amylase in Acute Pancreatitis

“…Karachaliou et al described a case report of a 64-year-old woman whose increased CK levels normalized throughout hospitalization in total of 12 days ( 23 ). Mao-Sheng Su et al published a case report about an alcoholic-cause AP but whose highly increased CK were related to another comorbidity – rhabdomyolysis ( 24 ). Shabestari et al described in their case report about the AP patients whose condition was caused by the anabolic steroids resulting in the acute increase of CK followed by high amylase levels ( 25 ).…”

Peripheral T‐cell lymphoma with unusual clinical presentation of rhabdomyolysis

“…Bertschy et al reported a patient who developed rhabdomyolysis after moderate alcohol abuse. Su et al reported two cases of pancreatitis with rhabdomyolysis also related to alcohol abuse. Therefore, it is likely that alcohol assumption may contribute to rhabdomyolysis.…”

Alcohol Induced Rhabdomyolysis

“…Ethanol causes rhabdomyolysis through disruption of Adenosine triphosphates pump function, break down of the muscle membrane, alteration of the sarcoplasmic reticulum, sodium permeability and disrupting calcium homeostasis, inducing cytokine releasing the levels of "interleukin (IL) 1, IL-2, IL-6", and" tumor necrosis factor α" (8)(9)(10)(11)(12).…”