Exercise-induced rhabdomyolysis manifestations and complications: a case report

Abstract

Introduction: Rhabdomyolysis is a medical condition that results from damage to striated muscles that causes the release of their components into the bloodstream. Laboratory indications include high levels of creatinine kinase and myoglobin in the serum. Importance: This case report emphasizes the importance of having professional trainers in gyms and training centers who respect trainees’ limitations and physical capabilities and ensure that physical exercise programs are being conducted safely and effectively. Case presentation: A 39-year-old female healthcare provider presented to the emergency department at a tertiary/quaternary hospital in Saudi Arabia, with progressive right arm pain, swelling, weakness, and dark urine 2 days after an unaccustomed heavy physical exercise session with her personal trainer following a long pause from physical training. Clinical discussion: Levels of serum creatinine kinase, aspartate aminotransferase, and alanine transaminase were moderately elevated. There was no evidence of renal impairment, electrolyte disturbance, or coagulopathy. The patient was treated with analgesics, received hydration, and was discharged home under close observation and with a follow-up clinic visit scheduled to check for complications. Data were collected from the hospital’s electronic medical records, including clinical notes and laboratory investigations. Conclusion: Awareness campaigns need to be conducted to educate the public about healthy ways to exercise, such as gradually increasing the intensity of physical activity, warming up before exercising, cooling down after each workout, and staying hydrated. It is important that healthcare providers, trainees and trainers are able to recognize the signs of muscular injury following vigorous exercise in order to reduce the incidences of complications that could be deadly if they are not caught and managed early.