Hypokalemic rhabdomyolysis in a child due to amphotericin B therapy

Silva, Paulo Sérgio Lucas da; Iglesias, Simone; Waisberg, Jaques

doi:10.1007/s00431-006-0208-y

Cited by 17 publications

(4 citation statements)

References 16 publications

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“…Hypokalaemia-induced rhabdomyolysis caused by c-AMB has been seldom reported and only in paediatric patients [18]. The true incidence of post-L-AMB rhabdomyolysis is unknown.…”

Section: Case Discussionmentioning

confidence: 99%

Hypokalaemia-Induced Rhabdomyolysis after Treatment of Post-Kala-azar Dermal Leishmaniasis (PKDL) with High-Dose AmBisome in Bangladesh—A Case Report

et al. 2014

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“…Hypokalaemia-induced rhabdomyolysis caused by c-AMB has been seldom reported and only in paediatric patients [18]. The true incidence of post-L-AMB rhabdomyolysis is unknown.…”

Section: Case Discussionmentioning

confidence: 99%

Hypokalaemia-Induced Rhabdomyolysis after Treatment of Post-Kala-azar Dermal Leishmaniasis (PKDL) with High-Dose AmBisome in Bangladesh—A Case Report

et al. 2014

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“…18,19 There are also reported incidences of hypokalemia-induced rhabdomyolysis in children from excessive vomiting, 20 11-hydroxylase deficiency, 21 celiac disease, 22 malabsorption in the setting of numerous intestinal resections, 23 and amphotericin B therapy. 24 Notably, there are no reports in the literature on hypokalemia from malnutrition leading to rhabdomyolysis.…”

Section: Discussionmentioning

confidence: 99%

Hypokalemia-Induced Rhabdomyolysis in a Child with Autism Affected by the COVID-19 Pandemic

Cao

Gaffney

Marcus

2021

J Dev Behav Pediatr

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Objective:Pediatric patients with autism spectrum disorder (ASD) often have coexisting feeding disorders. We hope to emphasize the significant implications that these feeding disorders can have on this patient population through a unique case of hypokalemia-induced rhabdomyolysis.Method:We present a unique case of a 3-year-old boy with ASD and a longstanding history of food selectivity whose routine was disrupted during the COVID-19 pandemic resulting in avoidant/restrictive food intake disorder and severe undernutrition, who presented with profound hypokalemia and was subsequently found to have elevated muscle enzymes consistent with rhabdomyolysis despite only subtle complaints of difficulty walking.Results:The patient was treated with aggressive hydration, electrolyte therapy, and nasogastric tube feeds, which resulted in clinical and biochemical evidence of improvement. He was also reconnected to ASD-related care services that had lapsed during the COVID-19 pandemic.Conclusion:This case exemplifies the adverse impact that feeding disorders can have on patients with ASD, particularly in the setting of stressors such as a global pandemic, and is also the first documented pediatric case of rhabdomyolysis secondary to hypokalemia from severe undernutrition. It demonstrates that physicians should have a low threshold to assess for clinical and laboratory evidence of rhabdomyolysis in patients with profound hypokalemia because symptoms of hypokalemia-induced rhabdomyolysis can often be subtle, which can delay diagnosis and thereby increase the risk for life-threatening complications from extensive muscle damage.

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“…Rhabdomyolysis, which may be subclinical in severity, has been reported to occur in up to 28% of hypokalemic patients admitted to the hospital [39]. Xenobiotics that have been reported to induce hypokalemic rhabdomyolysis include diuretics, mineralocorticoids, amphotericin B, and toluene [31,40,41]. Glycyrrhizin, a component of licorice used for its sweetness and distinctive flavor, has mineralocorticoid activity and has been implicated in rhabdomyolysis following its consumption in herbal medications, candies and beverages sweetened with the compound [42][43][44][45][46].…”

Section: What Other Xenobiotics Cause Rhabdomyolysis?mentioning

confidence: 99%

Case Files of the Medical Toxicology Fellowship at Drexel University

Vearrier

Curtis

2011

J. Med. Toxicol.

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A 28-year-old female was brought to the emergency department (ED) by her roommate after a suicide attempt, in which the patient took 29 capsules of an over-the-counter (OTC) sleep aid containing 50 mg of diphenhydramine (DPH) per capsule, for a total of 1450 mg, and consumed 100 ml of vodka. Her weight was 67 kg, yielding a dose of 22 mg/kg DPH. When a roommate arrived home from work several hours later, he noticed that the patient was walking aimlessly through the house and that "she was out of it." The patient subsequently informed the roommate of her suicide attempt, at which point he brought her by car to our ED. According to the patient, the ingestion occurred 9 h prior to arrival.In the ED, the patient complained of bilateral tingling and numbness in her legs and feet that had started within the last 4 h. She had a subjective sensation of inability to control the muscles in her legs and leg weakness. The patient denied any history of leg trauma, recent strenuous physical activity, or recent prolonged inactivity. Her medical history was significant for cervical dysplasia status post surgical excision and major depressive disorder. The patient denied taking any other prescribed or OTC medications, which her roommate corroborated.Physical examination revealed a young, disheveled female with normal body habitus. Initial vital signs included a temperature of 36.4°C, heart rate 123 beats/ min, respiratory rate 18 breaths/min, blood pressure 112/ 83 mm Hg, and pulse oximetry of 98% on room air. Pupils were 6 mm bilaterally and sluggishly reactive to light. Extraocular movements were intact. The mucous membranes of the oropharynx were dry. Cardiac examination was significant for a regular tachycardia, while the pulmonary examination was normal. Abdominal examination was significant for bowel sounds being present but decreased. The patient was alert and oriented to self and place, but not to time. She was able to answer simple questions, but was slow to respond. Strength, sensation, and deep tendon reflexes were normal. No ataxia or tremor was present. Extremity examination was significant for mottled skin color on the anterior legs bilaterally. Dorsalis pedis and posterior tibialis pulses were normal, as was sensation, strength, and capillary refill throughout the bilateral lower extremities. What is the Pharmacology of DPH?DPH is a first-generation H 1 antihistamine. It belongs to the ethanolamine subclass of antihistamines along with carbinoxamine, clemastine, dimenhydrinate, and doxylamine. Histamine receptors are categorized into four subtypes This case report was presented in poster form at the EAPCCT conference in 2009 in Stockholm, Sweden.

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Hypokalemic rhabdomyolysis in a child due to amphotericin B therapy

Cited by 17 publications

References 16 publications

Hypokalaemia-Induced Rhabdomyolysis after Treatment of Post-Kala-azar Dermal Leishmaniasis (PKDL) with High-Dose AmBisome in Bangladesh—A Case Report

Hypokalaemia-Induced Rhabdomyolysis after Treatment of Post-Kala-azar Dermal Leishmaniasis (PKDL) with High-Dose AmBisome in Bangladesh—A Case Report

Hypokalemia-Induced Rhabdomyolysis in a Child with Autism Affected by the COVID-19 Pandemic

Case Files of the Medical Toxicology Fellowship at Drexel University

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