1/130. "Abdominal crunch"-induced rhabdomyolysis presenting as right upper quadrant pain.A young, active duty sailor presented with right upper quadrant abdominal pain. history, physical, and laboratory findings initially suggested cholecystitis or related disease. Further evaluation found myoglobinuria and a recently increased exercise program, leading to the diagnosis of exercise-induced right upper abdominal wall rhabdomyolysis. Although not a common cause of abdominal pain, this diagnosis should be considered in the patient with abdominal pain and a recently increased exercise program, particularly exercises of the abdominal wall such as "abdominal crunches."- - - - - - - - - - ranking = 1keywords = sea (Clic here for more details about this article) |
2/130. Respiratory chain deficiency presenting as recurrent myoglobinuria in childhood.myoglobinuria is an abnormal urinary excretion of myoglobin due to an acute destruction of skeletal muscle fibres. Several metabolic diseases are known to account for myoglobinuria including defects of glycolysis and fatty acid oxidation. Here, we report on respiratory chain enzyme deficiency in three unrelated children with recurrent episodes of myoglobinuria and muscle weakness (complex I: one patient, complex IV: two patients). All three patients had generalized hyporeflexia during attacks, a feature which is not commonly reported in other causes of rhabdomyolysis. Studying respiratory chain enzyme activities in cultured skin fibroblasts might help diagnosing this condition, especially when acute rhabdomyolysis precludes skeletal muscle biopsy during and immediately after episodes of myoglobinuria.- - - - - - - - - - ranking = 1keywords = sea (Clic here for more details about this article) |
3/130. Muscle phosphofructokinase deficiency (Tarui's disease): report of a case.A 14-year-old girl had an acute episode of rhabdomyolysis after vigorous exercise and seizures. Laboratory studies revealed elevated creatine phosphokinase (CPK) activity and myoglobinuria without acute renal failure, as well as mild indirect hyperbilirubinemia, and hyperuricemia. The elevated CPK activity, mild indirect hyperbilirubinemia, and hyperuricemia persisted during a 10-month follow-up period, during which chronic hemolysis without overt anemia was also noted. A muscle biopsy specimen from the left biceps muscle revealed occasional muscle fiber necrosis and mild excess of glycogen accumulation on periodic acid-Schiff staining. Histochemical reactions were negative with phosphofructokinase (PFK) stain when fructose-6-phosphate was used as the substrate, but positive when fructose 1,6-bisphosphate was used as the substrate. These findings confirmed the diagnosis of muscle PFK deficiency (Tarui's disease), which is a defect of glycolysis in muscles and erythrocytes. Less than 40 such patients have been reported to date. When a specific metabolic myopathy is suspected in children with rhabdomyolysis, symptoms of hemolysis should also be sought to identify Tarui's disease. To the best of our knowledge, this is the first case of Tarui's disease identified in taiwan.- - - - - - - - - - ranking = 7keywords = sea (Clic here for more details about this article) |
4/130. Acute onset of dermatomyositis presenting in pregnancy with rhabdomyolysis and fetal loss.We report a case of acute onset of dermatomyositis with rhabdomyolysis and myoglobinuria, which presented in the 14th week of pregnancy and resulted in spontaneous abortion of the fetus. The diagnostic work up for an underlying disease was negative and the histologic examination confirmed the diagnosis of dermatomyositis, which subsequently improved with corticosteroids.- - - - - - - - - - ranking = 1keywords = sea (Clic here for more details about this article) |
5/130. neuroleptic malignant syndrome due to promethazine.A 42-year-old man came to our emergency room hyperthermic (oral temperature, 42.4 degrees C), diaphoretic, and delirious. Other findings included labile blood pressure, sinus tachycardia (heart rate, 138/min), tachypnea (respiratory rate 34/min), muscle rigidity, and incontinence. Two days earlier, he had gone to a local clinic with complaints of abdominal pain, nausea, and vomiting. promethazine was prescribed, and this was the patient's only medication on admission. Laboratory studies showed leukocytosis, hypernatremia, metabolic acidosis, elevated creatinine phosphokinase level, elevated transaminase levels, azotemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and myoglobulinuria. The clinical and laboratory findings were characteristic of the neuroleptic malignant syndrome, with promethazine as the offending agent.- - - - - - - - - - ranking = 1keywords = sea (Clic here for more details about this article) |
6/130. Acute renal failure and rhabdomyolysis after inadvertent intra-arterial infusion of excessive doses of epinephrine during cardiopulmonary resuscitation.Severe renal dysfunction or even acute renal failure necessitating renal replacement therapy are rather infrequent observations in patients following cardiopulmonary resuscitation. A low flow situation alone does not seem to be sufficient for renal breakdown and in addition other factors, such as preexisting renal disease, severe infections or congestive heart failure must be present. We report a patient, in whom during cardiopulmonary resuscitation a central venous catheter was placed which inadvertently was located in the aortic arch. Through this malpositioned line increasing and finally excessive amounts of epinephrine (in total 150 mg) were injected because of inadequate therapeutic response. After finally successful resuscitation the patient developed rhabdomyolysis and acute renal failure, which required hemodialyis therapy. Intraarterial infusion of the vasoconstrictor catecholamine obviously caused a critical reduction in renal and skeletal muscle perfusion. Nevertheless, the patient was discharged from hospital in good neurologic condition and with normal renal function.- - - - - - - - - - ranking = 1keywords = sea (Clic here for more details about this article) |
7/130. Haff disease: from the Baltic Sea to the U.S. shore.Haff disease, identified in europe in 1924, is unexplained rhabdomyolysis in a person who ate fish in the 24 hours before onset of illness. We describe a series of six U.S. patients from 1997 and report new epidemiologic and etiologic aspects. Although Haff disease is traditionally an epidemic foodborne illness, these six cases occurred in two clusters and as one sporadic case.- - - - - - - - - - ranking = 6keywords = sea (Clic here for more details about this article) |
8/130. colchicine induced rhabdomyolysis.A case of colchicine induced rhabdomyolysis is reported. A 73 year old man with ischaemic heart disease, atrial fibrillation, chronic congestive cardiac failure, and chronic gout presented with diffuse muscle pain. He had been taking an increased dose of colchicine (1.5 mg daily) for an exacerbation of gout for six weeks before the presentation. Investigations confirmed the diagnosis of rhabdomyolysis and discontinuation of colchicine resulted in resolution of clinical and biochemical features of rhabdomyolysis. Although neuromuscular adverse effects of colchicine are well recognised, rhabdomyolysis is rare and this is only the fourth reported case of colchicine induced rhabdomyolysis in the literature.- - - - - - - - - - ranking = 1keywords = sea (Clic here for more details about this article) |
9/130. rhabdomyolysis triggered by an asthmatic attack in a patient with McArdle disease.We describe a patient with McArdle disease who developed rhabdomyolysis triggered by a bronchial asthmatic attack. A 64-year-old man had chronic pulmonary emphysema with asthma, and an asthmatic attack led to severe rhabdomyolysis that required continuous hemodiafiltration. After 2 years, a physical examination revealed atrophy of the extremities compared with previous examinations, especially of the intercostal muscles. During that time, he suffered two severe bronchial asthmatic attacks. His serum level of creatinine kinase remained between 4,000 and 7,000 IU/l when he did not suffer from asthmatic attacks and rhabdomyolysis had abated. Therefore, we suspected that his recent muscle atrophy was caused by asthmatic attacks, and discussed the possibility of his respiratory muscle weakness due to McArdle disease in relation to his severe bronchial asthmatic attacks as well as chronic obstructive pulmonary disease.- - - - - - - - - - ranking = 7keywords = sea (Clic here for more details about this article) |
10/130. 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 = 2keywords = sea (Clic here for more details about this article) |
| | Next -> |