Fatal Rhabdomyolysis in Marathon Runner

Differential responses of serum and salivary interleukin-6 to acute strenuous exercise

“…Taken together, our data suggest that the magnitude of serum IL-6 increase during or after exercise should not be considered predictive of complications due to strenuous effort, such as the acute compartment syndrome, with the consequent ischemia and damage to the structures within the compartment (Bertoldo et al 2003;Bidwell et al 1996;Brodsky and Bongiovanni 2000;Fehlandt and Micheli 1995;Kahan et al 1994;Kuklo et al 2000;Leach et al 1967;Lonka and Pedersen 1987;McHale and Prahinski 1994;McKee and Jupiter 1995;Nau et al 2000;Power and Greengross 1991;Presnal and Heavilon 1995;Robinson SJ (2000); Wise and Fortin 1997). In a recent study, Bertoldo et al (2003) reported a case of acute bilateral exercise-induced compartment syndrome of the thigh in a man who had performed a spinning activity for 1 h; the pressure of the anterior compartment was bilaterally elevated, as were the serum levels of muscle enzymes.…”

Acute Anterior Thigh Compartment Syndrome Revisited: A Case Report and Review of Literature

“…He had brownish discoloration of the urine 12 h post over exertion. Other cases of overexertion reported in literature were by Lonka et al [23] of a 27-year-old marathon runner, Presnal et al [24] and Kuklo et al [25], where they reported similar cases. In each of the reported cases the treatment was immediate surgical intervention followed by full recovery as it was in our case.…”

“…Being a rare entity, it is not surprising to find only nine reported cases of acute non traumatic anterior thigh compartment syndrome in the English literature that have been caused purely by over exertion [17][18][19][20][21][22][23][24][25].…”

Rhabdomyolysis and conservatively managed bilateral compartment syndrome of the thighs following strenuous exercise

“…Several cases of exertional rhabdomyolysis and ensuing thigh compartment syndrome have also appeared in the literature following weight training, performance of squats, following a marathon and following a 2 mile run. 2,6,7,11,12,18,19,22,25 To the authors' knowledge only one previous report exists following so-called 'spinning' training for which the gentleman in question had to undergo bilateral fasciotomies. 1 All these cases share a common trend of a single episode of abnormal training behaviour associated with ensuing hypertrophy and oedema of the quadriceps and adductors in one case.…”

“…2,6,7,11,12,18,19,22,25 Compartment syndrome of the thigh is also an unusual presentation due to the relative size and room for expansion within the three fascial compartments of the thigh. It normally occurs as a result of femoral fracture and other trauma, particularly involving crush injuries.…”