1/56. Fatal multi-organ failure after suicidal overdose with MDMA, 'ecstasy': case report and review of the literature.A 53-year-old prisoner died of multiorgan failure after a suicidal overdose with 3,4-methylenedeoxymethamphetamine (MDMA, 'Ecstasy'). Twelve hours after ingestion of MDMA, the patient became severely hyperthermic (107.2 degrees F) with evidence of rhabdomyolysis. He subsequently developed acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC) and acute renal failure. At autopsy, plasma concentration of MDMA was 3.05 mg/L. This case shows that MDMA is still abused in our community and clinicians should know the symptoms of MDMA intoxication. In particular, MDMA should be considered when patients have symptoms or signs of increased sympathetic activity. The pathophysiology and treatment of MDMA-induced hyperthermia are discussed.- - - - - - - - - - ranking = 1keywords = intravascular, coagulopathy (Clic here for more details about this article) |
2/56. rhabdomyolysis complicating unrecognized hypophosphatemia in an alcoholic patient.rhabdomyolysis occurring as a complication of hypophosphatemia has been infrequently described. A 58-year-old male with a history of daily alcohol consumption presented with two generalized tonic clonic seizures secondary to hypovolemic hyponatremia. He was volume-resuscitated, and antiepileptic medication was administered. After three days of hospitalization, the patient developed severe rhabdomyolysis despite the absence of further seizure activity. serum phosphate levels were depressed. He was treated with intravenous mannitol, alkaline diuresis, and intravenous and oral phosphate supplementation. He recovered uneventfully. hypophosphatemia can potentially lead to multisystem organ dysfunction including severe rhabdomyolysis. It is, therefore, important to maintain a low threshold for measuring serum phosphate levels in patients admitted to hospital.- - - - - - - - - - ranking = 2.1051954015133keywords = consumption (Clic here for more details about this article) |
3/56. Disseminated zygomycosis due to rhizopus schipperae after heatstroke.A 21-year-old woman suffered heatstroke and developed diarrhea while trekking across south texas. The heatstroke was complicated by seizures, rhabdomyolysis, pneumonia, renal failure, and disseminated intravascular coagulation. The patient's stool and blood cultures grew campylobacter jejuni. The patient subsequently developed paranasal and gastrointestinal zygomycosis and required surgical debridement and a prolonged course of amphotericin b. The zygomycete cultured was rhizopus schipperae. This is only the second isolate of R. schipperae that has been described. R. schipperae is characterized by the production of clusters of up to 10 sporangiophores arising from simple but well-developed rhizoids. These asexual reproductive propagules are produced on Czapek Dox agar but are absent on routine mycology media, where only chlamydospores are observed. Despite multiorgan failure, bacteremia, and disseminated zygomycosis, the patient survived and had a good neurological outcome. Heatstroke has not been previously described as a risk factor for the development of disseminated zygomycosis.- - - - - - - - - - ranking = 8.5916459982763keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
4/56. rhabdomyolysis associated with infection by mycoplasma pneumoniae: a case report.BACKGROUND. mycoplasma pneumoniae is responsible for approximately 20% of the cases of community-acquired pneumonia. The onset of respiratory symptoms is gradual and systemic complaints such as headache, malaise, arthalgias, and low-grade fever are frequently prominent. Extrapulmonary manifestations of M pneumoniae are common and hematologic (thrombocytopenia, splenomegaly, disseminated intravascular coagulation, hemolytic anemia), dermatologic (stevens-johnson syndrome), gastrointestinal (vomiting, diarrhea, pancreatitis), renal (interstitial nephritis, glomerulonephritis), cardiac (pericarditis, myocarditis, pericardial effusion) and central nervous system (meningitis, transverse myelitis, polyradiculopathy, cerebellar ataxia, sensorineural hearing loss) complications can occur. observation. We describe the case of an adolescent girl with massive rhabdomyolysis associated with an infection caused by M pneumoniae. We briefly review the differential diagnosis of a patient presenting with acute rhabdomyolysis and discuss the use of a new polymerase chain reaction-based assay for direct detection of M pneumoniae in throat swab specimens. CONCLUSION. Clinicians should be aware of a possible association between rhabdomyolysis and infection with M pneumoniae and should consider testing for M pneumoniae when they are presented with a patient with idiopathic rhabdomyolysis. The new polymerase chain reaction-based assay for detection of M pneumoniae is a more accurate and more efficient method than traditional culture.- - - - - - - - - - ranking = 8.5916459982763keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
5/56. Unusual consequences of heroin overdose: rhabdomyolysis, acute renal failure, paraplegia and hypercalcaemia.A 29-yr-old man, known to be a heroin addict, was found at home totally unrousable, bent on his hips in the lotus position. On admission, he required frequent ventricular defibrillation, external pacing and infusion of calcium. A diagnosis of rhabdomyolysis caused by heroin and cocaine overdose was made. He developed paraplegia below T12, acute renal failure, acute compartment syndrome in one leg and a coagulation defect. Despite a fasciotomy, a through-knee amputation of the leg was required. Haemodialysis was required for 26 days, and this period was complicated by increased serum calcium concentrations, which was treated with disodium pamindrate. calcium deposits were palpable in the muscles and could be seen in vessels on limb x-rays. After 34 days, he was eventually discharged to a general surgical ward and subsequently into the community.- - - - - - - - - - ranking = 0.33754426019205keywords = coagulation (Clic here for more details about this article) |
6/56. A case of cytophagic histiocytic panniculitis associated with exertional rhabdomyolysis.An 18-year-old man who suffered from panniculitis involving the entire left lower limb after exertional rhabdomyolysis is reported. A high fever (>39 degrees C) and leukocytosis (>20,000/microL) persisted for 1 week, and his general status deteriorated rapidly into pre-disseminated intravascular coagulation, complicated by pleural effusion and prolonged clotting time. His condition was dramatically improved by steroid pulse therapy and he has remained in good health for the 20 months since discharge. Histologic examination of subcutaneous tissue from the swollen left lower limb revealed pleomorphic small, medium or large lymphocytes, macrophages and neutrophils infiltrating the edematous subcutaneous adipose tissue in a lobular panniculitis-like pattern. The majority of inflammatory cells were T lymphocytes, with equal proportions of CD4 and CD8 cells. As polymerase chain reaction did not show bands suggesting T cell receptor gamma gene rearrangement, the proliferation of T lymphocytes was considered to be polyclonal. The T lymphocytes also expressed Fas ligand, suggesting the involvement of Fas-mediated cytotoxicity. This case may represent a new category of cytophagic histiocytic panniculitis induced by exertional rhabdomyolysis.- - - - - - - - - - ranking = 8.5916459982763keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
7/56. Increased anaerobic glycolysis in mitochondrial trifunctional protein-deficient brain.Deficiency of mitochondrial trifunctional protein (TP), beta-oxidation enzyme, is characterized by recurrent rhabdomyolysis in adult patients. Positron emission tomography was used to measure brain oxygen (CMRO(2)) and glucose (CMRGlc) metabolisms in an adult patient with TP deficiency who had a homozygous G1331A transition of the beta-subunit gene. The molar ratio of oxygen to glucose consumption showed diffuse reduction; CMRO(2) was markedly decreased, whereas CMRGlc increased. Oxidative metabolism may be impaired and anaerobic glycolysis stimulated in the brain of this patient with TP deficiency.- - - - - - - - - - ranking = 2.1051954015133keywords = consumption (Clic here for more details about this article) |
8/56. Invasive Group C streptococcus infection associated with rhabdomyolysis and disseminated intravascular coagulation in a previously healthy adult.Infections with Group C Streptococci can lead to severe disease, particularly in individuals with underlying illnesses such as cardiovascular disease, malignancy or immunosuppression. We report the first case of rhabdomyolysis and disseminated intravascular coagulation secondary to Group C streptococcus in a previous healthy male. A toxic shock-like syndrome associated with Group C and Group G Streptococci has been reported. However, unlike with Group A Streptococci, production of endotoxins by these organisms is less well defined. We tested the patient's isolate for its ability to produce superantigenic toxins and to induce a mitogenic response. Although it is not known whether Group C Streptococci require special growth conditions for the production of superantigens, we could not demonstrate either the production of exotoxins or the induction of a mitogenic response.- - - - - - - - - - ranking = 42.958229991382keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
9/56. Pathogenesis and treatment of rhabdomyolysis.PURPOSE: To provide clinicians in primary and acute care settings with information on the evaluation, diagnosis, and treatment of rhabdomyolysis. DATA SOURCES: Selected review articles from print and electronic sources, and a case study. CONCLUSIONS: rhabdomyolysis is a common disorder, which may result from a large variety of diseases, trauma, or toxic insults to skeletal muscle. It is caused by skeletal muscle injury and results in the release of muscle contents (i.e., myoglobin) into the plasma. Muscular, urinary, and general internal disturbances are the three areas where signs and symptoms occur. IMPLICATIONS FOR PRACTICE: Clinical signs and symptoms vary widely. Associated life-threatening complications include acute renal failure, cardiac arrhythmias and arrest, disseminated intravascular coagulation, and compartment syndrome. Early recognition and treatment in the acute phase of rhabdomyolysis are keys to successful outcomes and an excellent recovery.- - - - - - - - - - ranking = 8.5916459982763keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
10/56. Acute renal failure after thrombotic agent therapy due to excessive bleeding after cosmetic liposuction.suction lipoplasty is practiced popularly for obesity control and cosmetic purposes and severe complications are rare. We report the first documented case of acute renal failure, with anuric period, that developed after excessive bleeding following cosmetic liposuction. The use of homocoagulase and the presence of rhabdomyolysis might have contributed to the acute renal failure and disseminated intravascular coagulation observed in this case.- - - - - - - - - - ranking = 8.5916459982763keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
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