Myoglobinuria Following Diabetic Acidosis&lt;subtitle&gt;With Electromyographic Evaluation&lt;/subtitle&gt;

Rainey, Robert L.

doi:10.1001/archinte.1963.03620290030006

Cited by 23 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been proposed by Rainey et al [1] that decreased cellular utilization of carbohydrates in diabetic ketoacidosis -reflected by elevated blood glucose concentration -may result in deprivation of an important source of energy for muscle cells, leading to cellular damage. This hypothesis assumes that the muscles cannot preserve adequate metabolism by other metabolic pathways.…”

Section: Discussionmentioning

confidence: 99%

“…Nontraumatic rhabdomyolysis during diabetic ketoacidosis complicated with anuria or acute renal failure has been described earlier in only 4 case reports [1][2][3][4]. However, the findings by other investigators of elevated serum activity of creatine phosphokinase and the observation of a positive urine test for haemoglobin in the absence of haematuria may indicate that damage to striated muscle cells with hypermyoglobinaemia and myoglobinuria accompanying diabetic ketoacidosis may be more frequent than previously recognized [5][6][7].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Nontraumatic rhabdomyolysis during diabetic ketoacidosis

Møller-Petersen

Pt²,

Hjörne

et al. 1986

Diabetologia

View full text Add to dashboard Cite

Summary. The frequency of nontraumatic rhabdomyolysis in diabetic ketoacidosis was investigated by serial measurements of the serum levels of myoglobin and the serum activity of creatine kinase isoenzyme MM in 12 consecutively admitted ketoacidotic patients. In 5 patients (Group 1) we found hypermyoglobinaemia and elevated activity of creatine kinase isoenzyme MM on admission to hospital, whereas these two variables were normal in 7 patients (Group 2). On admission significantly higher median blood glucose levels and higher median serum osmolality were found in Group 1 than in Group 2 (for blood glucose: 49.6 mmol/1 versus 19.0 mmol/1, p<0.02; for serum osmolality: 360mosm/kg H20 versus 315 mosm/kg H20, p <0.05). Decreased renal function was found in Group 1 as reflected by significantly higher betarmicroglobulin serum concentrations in Group 1 compared with Group 2 on admission (median values 4.1 mg/1 versus 1.7 mg/1, p < 0.01) and during the first 3 days of therapy. The serum concentration of hypoxanthine (an indicator of the cellular energy state) was elevated in all patients on admission, with no difference between patients with or without hypermyoglobinaemia. In conclusion, our findings suggest that nontraumatic rhabdomyolysis with hypermyoglobinaemia and elevated serum activity of creatine kinase isoenzyme MM may be a hitherto unrecognized common feature of diabetic ketoacidosis.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Nontraumatic rhabdomyolysis during diabetic ketoacidosis

Møller-Petersen

Pt²,

Hjörne

et al. 1986

Diabetologia

View full text Add to dashboard Cite

show abstract

“…Unfortunately, many of the patients included in this study and the study reported by Velez-Garcia et al [5] were administered insulin by intramuscular injection. Intramuscular injection inde pendently is known to cause an elevation of serum CPK [4], This may have been a major contributing factor to an elevation of serum CPK during insulin therapy be sides the direct effect of insulin in many of the pre viously reported patients [5][6][7], An interesting case of primary myoglobinuria following diabetic acidosis has also been reported earlier [7], That patient experienced repeated muscle cramps while rapidly recovering from hyperglycemia. He subsequently developed myoglobinu ria and renal failure.…”

Section: Discussionmentioning

confidence: 99%

“…Dia betic patients in an acidotic state have been reported to develop rhabdomyolysis in a few instances [5][6][7], In most of these patients, initiation of insulin therapy has been incriminated for the induction of rhabdomyolysis [5][6][7], In the majority of these cases, insulin was admin istered by the intramuscular route which may have con tributed to the induction of rhabdomyolysis [4], Al though hypokalemia, hypernatremia and the hyperosmolal state are common occurrences in diabetes, these conditions have only been incriminated rarely in the induction of nontraumatic rhabdomyolysis in hypergly cemic patients. To evaluate the determinants of rhabdo myolysis in diabetic patients, we compared and con trasted the clinical and biochemical features observed in diabetic patients with and without rhabdomyolysis.…”

mentioning

confidence: 99%

Determinants of Rhabdomyolysis in the Diabetic State

et al. 1991

View full text Add to dashboard Cite

To evaluate the determinants of rhabdomyolysis in the diabetic state, we compared biochemical and clinical features of diabetic patients with (group 1, 41 patients) and without (group 2, 36 patients) rhabdomyolysis. There was no difference in values for serum potassium, bicarbonate, phosphate and calcium between the two groups. Nineteen patients in group 2 and 21 patients in group 1 were hypokalemic. The mean serum sodium level was higher (p < 0.001) in group 1 patients (148.8 ± 2.1 mEq/l) than in group 2 patients (135.0 ± 1.1 mEq/1). Only 1 patient was hypernatremic in group 2, whereas 24 patients had hypernatremia in group 1. Linear regression of the creatine phosphokinase values versus serum sodium levels suggested a high correlation (p < 0.001). The mean blood glucose level was higher (p < 0.05) in group 1 patients (640.8 ± 80.3 mg/dl) when compared to group 2 patients (436.0 ± 56.7 mg/dl). There was a linear association (p < 0.05) between the levels of blood glucose and creatine phosphokinase values in the patients with rhabdomyolysis. The mean serum osmolality was 350.3 ± 8.2 mosm/kg in group 1 patients as compared to 304.9 ± 3.6 mosm/kg in group 2 patients (p < 0.001). There was also a significant correlation (p < 0.001) between the serum osmolality levels and the serum creatine phosphokinase values in group 1 patients. We conclude that serum sodium, serum osmolality and blood glucose are the major determinants for the occurrence of rhabdomyolysis in the diabetic state.

show abstract

“…Rhabdomyolysis associated with diabetic ketoacidosis has also been re ported (3)(4)(5), but cases of CMV infection etiologically related to rhabdomyolysis are rare. Only one previous case report in which CMV infection is thought to be an etiologic factor of rhabdomyolysis appears in the literature (6).…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus Infection Associated with Acute Pancreatitis, Rhabdomyolysis and Renal Failure.

et al. 1992

View full text Add to dashboard Cite

The occurrence of rhabdomyolysis and acute renal failure associated with cytomegaloviral infection is rare. A 27-year-old housewife was admitted to our hospital with complaints of thirst, muscle weakness, abdominal pain and oliguria. There was no past history of diabetes, drinking, fever or drug habituation and a negative family history. Laboratory tests revealed myoglobi nuria, hyper-pancreatic type amylaseuria, hyperglycemia, azotemia and highly increased creatine phosphokinase in the plasma. She was treated with hemodialysis and insulin therapy. Serological studies showed a 4-fold increase in cytomegalovirus antibody titers 4 weeks after admission. Muscle biopsy specimens showed hyaline degeneration and infiltration of T cell lymphocytes in the muscle. Renal biopsy specimens showed acute tubular necrosis and some myoglobin casts. No cytomegalovirus antigen was found in renal specimens by immunofluorescence study. From these results, it was determined that a systemic cytomegalovirus infection triggered pancreatitis which caused diabetic ketoacidosis, rhabdomyolysis and acute renal failure. (Internal Medicine 31: 426-430, 1992)

show abstract

Myoglobinuria Following Diabetic Acidosis<subtitle>With Electromyographic Evaluation</subtitle>

Cited by 23 publications

References 14 publications

Nontraumatic rhabdomyolysis during diabetic ketoacidosis

Nontraumatic rhabdomyolysis during diabetic ketoacidosis

Determinants of Rhabdomyolysis in the Diabetic State

Cytomegalovirus Infection Associated with Acute Pancreatitis, Rhabdomyolysis and Renal Failure.

Contact Info

Product

Resources

About