Rhabdomyolysis in a Teenage Boy: A Case Report

Abstract

Rhabdomyolysis is a potentially lethal syndrome with a wide range of metabolic and clinical aspects. It is caused by skeletal muscle injury that results in the release of myoglobin and other cellular contents into the circulatory system. 1 Multiple factors predispose someone to this illness. Preventive measures can avoid the onset of this syndrome, and a timely diagnosis and proper management can avert life-threatening complications. This report describes a case of exertional rhabdomyolysis in a patient who sought treatment for bilateral leg pain.

Rhabdomyolysis: Diagnosis and Treatment in Bariatric Surgery

“…Local signs and symptoms are non-specific and may include muscle pain, tenderness, swelling, bruising and weakness. 7,10,11 Myoglobinuria is suspected with the presence of altered urine color 7 and requires differential diagnosis among several entities. During the physical examination, decubitus ulcer and eruptions can be present in pressure zones, mainly at the hips, limbs and buttocks.…”

“…12,13 Usually, the first systemic clinical sign is the appearance of urine with altered color that can range from pink, to brown, and black. 2 The elevation in CPK levels is the most sensitive diagnostic evidence of muscle injury 8,11,14 and is present in 100% of RML cases. 13,14 Laboratory Findings Although history and physical examination can provide clues, the actual diagnosis of RML is confirmed by laboratory studies.…”

“…5,8,10,29 These measures help to prevent volume depletion, tubular obstruction, aciduria, and free radical release which is the mechanism for renal failure in rhabdomyolysis. 1,11,30 Expanding the intravascular volume maximizes renal excretion by flushing out the tubular debris and limiting the time that nephrotoxins are in contact with renal tissues. 1,11,30 Expanding the intravascular volume maximizes renal excretion by flushing out the tubular debris and limiting the time that nephrotoxins are in contact with renal tissues.…”

“…Mannitol is an osmotic diuretic that increases urinary flow and prevents obstructive myoglobin casts, and mannitol scavenges free radicals. 11 The use of sodium bicarbonate helps to correct the acidosis induced by the release of protons from damaged muscles to prevent precipitation of myoglobin in the tubules and reduce the risk of hyperkalemia. 5,33 They increase tubular flow and calcium losses and decrease the risk of precipitation of myoglobin, 1 although they may acidify the urine.…”

Blood labile iron effect on nitrosative stress development under rat experimental rhabdomyolysis

“…Роз-виваються структурні зміни в нирках, головним чином у канальцях. Наслідком цьо-го є гостра ниркова недостатність, яка виникає приблизно через 24-48 год після початкового пошкодження м'язів, незалежно від виду фактора, який спричинив даний патологічний стан та є домінуючим проявом даної патології [8].…”