Nephro-Zebra: acute kidney injury secondary to rhabdomyolysis—a rare and reversible cause

Watson, Samuel A.; Rosenberg, Kerry-Lee; Bramham, Kate; Alston, Helen

doi:10.1007/s40620-021-01166-z

Cited by 1 publication

(1 citation statement)

References 4 publications

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“…However, the clinical manifestations differ vastly, ranging from asymptomatic to sharp increases in creatine kinase, myoglobin, lactate dehydrogenase, and occasionally acute renal insufficiency and disseminated intravascular coagulation, which are life-threatening. Common predisposing factors for RM are trauma, certain drugs (such as statins[ 3 ]), alcohol[ 4 ], infection[ 5 ], muscle hyperactivity, genetic diseases[ 6 ], endocrine abnormalities[ 7 ], and tumors[ 8 ]. During multiple chemotherapy sessions, this patient developed severe infections but not RM.…”

Section: Discussionmentioning

confidence: 99%

Cytokine release syndrome complicated with rhabdomyolysis after chimeric antigen receptor T-cell therapy: A case report

Zhang¹,

Chen²,

Wang³

et al. 2022

WJCC

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BACKGROUND Chimeric antigen receptor T-Cell (CAR-T) therapy is an effective new treatment for hematologic malignancies. Cytokine release syndrome (CRS) and neurologic toxicity are main toxicities. CRS-induced rhabdomyolysis (RM) followed by CAR-T therapy treatment has not been previously reported. CASE SUMMARY We report a case of a 22-year-old woman with relapsed acute lymphoblastic leukemia obtained sequential cluster of differentiation (CD) 19 and CD22 CAR-T infusion. This patient experienced grade 3 CRS with RM, mild hypotension requiring intravenous fluids, and mild hypoxia and was managed effectively with the IL-6 receptor antagonist tocilizumab. This patient had no signs of immune effector cell-associated neurologic syndrome. Restaging scans 30 d postCAR-T therapy demonstrated a complete remission, and the symptoms of muscle weakness improved through rehabilitation. CONCLUSION Myalgia is an easily overlooked symptom of severe CRS after CAR-T therapy. It is necessary to monitor myoglobin levels when a patient presents with symptoms of myalgia or acute renal insufficiency.

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