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Zhining Wen, Yu Liang, Yingyi Hao, Brian Delavan, Ruili Huang, Mike Mikailov, Weida Tong, Menglong Li, Zhichao Liu
Drug-induced rhabdomyolysis (DIR) is an idiosyncratic and fatal adverse drug reaction (ADR) characterized in severe muscle injuries accompanied by multiple-organ failure. Limited knowledge regarding the pathophysiology of rhabdomyolysis is the main obstacle to developing early biomarkers and prevention strategies. Given the lack of a centralized data resource to curate, organize, and standardize widespread DIR information, here we present a Drug-Induced Rhabdomyolysis Atlas (DIRA) that provides DIR-related information, including: a classification scheme for DIR based on drug labeling information; postmarketing surveillance data of DIR; and DIR drug property information...
June 11, 2018: Drug Discovery Today
Joseph I Clark, Shams Bufalino, Shruti Singh, Ewa Borys
BACKGROUND: The treatment options for metastatic malignant melanoma have drastically changed recently,including the increased use of immunotherapeutic agents that offer significant responses. Accordingly, it hasbecome common for sequential administration of such agents. Despite this, no guidelines exist on propersequencing or potential unique toxicities associated with such sequencing. CASE PRESENTATION: We describe here the first incidence, to our knowledge, of clinically significant rhabdomyolysis associated with high-dose interleukin-2 after prior treatment with ipilimumab, genetically engineered T-cell therapy and subsequent single agent pembrolizumab in a patient with BRAF wild type metastatic malignant melanoma...
June 14, 2018: Journal for Immunotherapy of Cancer
Veronica C Devall, Robert Goggs, Christina Hansen, Christopher W Frye, Jo-Annie Letendre, Joseph J Wakshlag
OBJECTIVE: To evaluate whether cell-free DNA (cfDNA) concentrations are increased in dogs with exertional rhabdomyolysis and whether concentrations are correlated with serum myoglobin concentration and creatine kinase activity. DESIGN: Observational cohort study. SETTING: Yukon Quest 1,000-mile International Sled Dog Race 2015. ANIMALS: Twelve normal competitive sled dogs; 5 dogs with rhabdomyolysis. INTERVENTIONS: None...
June 13, 2018: Journal of Veterinary Emergency and Critical Care
Andoni Echaniz-Laguna, Valérie Biancalana, Pauline Gaignard, Jean-Baptiste Chanson
Rhabdomyolysis is an emergency requiring rapid diagnosis and suitable aetiological treatment. We describe the case of a 57-year-old man with recurrent exertional rhabdomyolysis who was diagnosed with systemic primary carnitine deficiency (SPCD). Clinical examination was normal, creatine kinase levels were elevated, plasma free carnitine concentration was mildly decreased, muscle biopsy demonstrated lipid accumulation, carnitine uptake in cultured fibroblasts was decreased and genetic analysis identified a homozygous pathologic c...
June 11, 2018: BMJ Case Reports
Kadhiresan R Murugappan, Michael N Cocchi, Somnath Bose, Sara E Neves, Charles H Cook, Todd Sarge, Shahzad Shaefi, Akiva Leibowitz
Rapid weight loss or "weight cutting" is a dangerous practice that is ubiquitous in modern combat sports yet underrepresented in the medical literature. We present a case of exertional rhabdomyolysis in a mixed martial artist with sickle cell trait in order to illustrate the hazards of weight cutting and ensuing critical illness. Sickle cell trait is known to predispose patients to exertional rhabdomyolysis and multiple fatal cases have been reported in the setting of strenuous exercise. Dehydration and consequent electrolyte abnormalities make combat sport athletes with sickle cell trait particularly vulnerable to this entity...
June 12, 2018: International Journal of Sport Nutrition and Exercise Metabolism
Jacques A J Malherbe, Sue Davel
BACKGROUND Rhabdomyolysis and primary dilated cardiomyopathies without skeletal muscle weakness are rare features of X-linked dystrophinopathies. We report a rare case of an X-linked dilated cardiomyopathy (XLDCM) presenting with acute rhabdomyolysis and myocarditis. We illustrate the confounding diagnostic influence of a reactivated, persistent EBV myocarditis as the presumed cause for this patient's XLDCM. CASE REPORT A 23-year-old Australian man presented with acute rhabdomyolysis and elevated creatine kinase (CK) levels...
June 12, 2018: American Journal of Case Reports
Zhan Lu, Yan-Bo Chen, Bo Huang, Sheng Peng, Qian-Wen Wang, Dan-Lei Liu, Hua Wang
We report the clinical characteristics, treatments and outcomes of 4 rare cases of mixed amanita fuliginea and amanita rimosa poisoning with rhabdomyolysis, and review the research progress in the intoxication mechanism and treatment. The latent time of amanita poisoning, defined as the period from the ingestion of poisonous mushroom to the onset of gastrointestinal symptoms, was about 8 days, and the severity of poisoning was associated with the amount of mushroom ingested. All the 4 patients developed multiple organ dysfunctions within 3 to 4 days after mushroom ingestion, predominantly in the liver, kidney and central nervous system accompanied with acute gastrointestinal injury and rhabdomyolysis...
May 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Joshua Krieger, Donald Sims, Cameron Wolterstorff
Blood flow-restricted resistance (BFRR) training is effective as a means to improve muscle strength and size while enduring less mechanical stress. It is generally safe but can have adverse effects. We present a case of an active duty Soldier who developed rhabdomyolysis as a result of a single course of BFRR training. He was presented to the emergency department with bilateral lower extremity pain, was admitted for electrolyte monitoring and rehydration, and had an uncomplicated hospital course and full recovery...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Harika Puttagunta, Saleh Alghsoon, Prudhvi Regula, Shruthimurthy Hassankrishnamurthy, Vamsi K Kota
BACKGROUND Tamiflu (oseltamivir phosphate) serves as prophylaxis and treatment of upper respiratory tract infections (URTI) and lower respiratory tract infections (LRTI) caused by viruses of the Orthomyxovirus family. Here, we present a patient with URTI and negative rapid influenza diagnostic testing (RIDT), who developed rhabdomyolysis after being started on oseltamivir. CASE REPORT Our report describes a rare case of rhabdomyolysis after oseltamivir administration in a 53-year-old man with suspected influenza...
June 11, 2018: American Journal of Case Reports
Alice J Sharpe, Matthew McKenzie
Mitochondrial fatty acid β-oxidation (FAO) is the primary pathway for fatty acid metabolism in humans, performing a key role in liver, heart and skeletal muscle energy homeostasis. FAO is particularly important during times of fasting when glucose supply is limited, providing energy for many organs and tissues, including the heart, liver and brain. Deficiencies in FAO can cause life-threatening metabolic disorders in early childhood that present with liver dysfunction, hypoglycemia, dilated hypertrophic cardiomyopathy and Reye-like Syndrome...
May 23, 2018: Cells
Bing Han, Tong Cheng, Lin Ye, Chunhua Sui, Lizhen Yang, Dongping Lin, Jie Qiao, Yingli Lu
Hypothyroidism was a rare cause of rhabdomyolysis, which finally progressed to acute kidney injury (AKI). We compared nine patients with AKI secondary to hypothyroidism and six patients with severe hypothyroidism. Besides creatine kinase, globulin could be an alternative biomarker of rhabdomyolysis related to hypothyroidism.
June 2018: Clinical Case Reports
Anna Capaldo, Flaminia Gay, Marilena Lepretti, Gaetana Paolella, Stefania Martucciello, Lillà Lionetti, Ivana Caputo, Vincenza Laforgia
The presence of illicit drugs in the aquatic environment represents a new potential risk for aquatic organisms, due to their constant exposure to substances with strong pharmacological activity. Currently, little is known about the ecological effects of illicit drugs. The aim of this study was to evaluate the influence of environmental concentrations of cocaine, an illicit drug widespread in surface waters, on the skeletal muscle of the European eel (Anguilla anguilla). The skeletal muscle of silver eels exposed to 20 ng L-1 of cocaine for 50 days were compared to control, vehicle control and two post-exposure recovery groups (3 and 10 days after interruption of cocaine)...
June 4, 2018: Science of the Total Environment
Hyeok Dong Lee, Sung Young Lee, Young-Shin Cho, Seung Hoon Han, Si-Bog Park, Kyu Hoon Lee
RATIONALE: Peripheral neuropathy is a rare complication of carbon monoxide intoxication. Peripheral neuropathy following carbon monoxide intoxication is known to completely recover within a few months. PATIENT CONCERNS: A 40-year-old man complained of motor weakness and hypoesthesia of the right lower extremity with swelling of his right thigh after carbon monoxide intoxication resulting from a suicide attempt. DIAGNOSES: Following nerve conduction and electromyographic studies, the patient was diagnosed with sciatic neuropathy with severe axonopathy...
June 2018: Medicine (Baltimore)
Amna Hamid, Murtaza F Dhrolia, Ruqayya Qureshi, Salman Imtiaz, Aasim Ahmad
Chikungunya fever is an arthropod-borne viral illness characterised by high grade fever and incapacitating arthralgias. It is considered benign; however, in the recent outbreaks, several complications have been reported worldwide. We report a case of male patient with Chikungunya fever, possibly contracted from infected mosquitoes endemic in Karachi, Pakistan. The clinical presentation included fever, myalgias and anuria. Investigations revealed renal failure and significantly raised creatinine phosphokinase (CPK), suggesting rhabdomyolysis to be the cause of acute kidney injury (AKI)...
June 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Caroline Ratnam, Emeric Saguin, Symphonie Keou, Julie Plantamura, Coralie Mennessier, Bertrand Lahutte, Hervé Delacour
We report the case of a 40-year-old patient followed for post-traumatic stress disorder. A re-evaluation of its pharmacological treatment with the introduction of mirtazapine (30 mg/day) was associated with a rhabdomyolysis (CK> 20,000 IU/L at day 3). The diagnosis of mirtazapine induced rhabdomyolysis was made. After withdrawal of this drug combined with a symptomatic treatment (hydratation), the patient recovered well and was discharged without any nephrological sequelae. This article is intended to underline the diagnostic approach to elevated CK activity and the potential role of the "medical biologist" as a consultant for the relevant use of biological examinations...
June 1, 2018: Annales de Biologie Clinique
W L Jabur, P Nasa, K A Mohammed, A Kulkarni, S N Tomaraei
Exercise-induced rhabdomyolysis (EIR) is an uncommon cause of severe rhabdomyolysis and a very rare cause of acute kidney injury (AKI). A prospective observational study of 25 patients diagnosed with EIR was conducted in a multispecialty hospital in Dubai, from 2009 to 2015. Five out of 25 patients experienced AKI necessitating temporary renal replacement therapy. The initial presentation, biochemical parameters, and clinical course of patients were monitored, to understand epidemiology and risk factors for the development of AKI...
March 2018: Indian Journal of Nephrology
Hyunbeom Lee, Jong Min Choi, Joo-Youn Cho, Tae-Eun Kim, Hwa Jeong Lee, Byung Hwa Jung
Rosuvastatin is a statin used to treat metabolic syndrome conditions, such as hyperlipidemia. It is relatively safe; however, fatal rhabdomyolysis or skeletal myopathy can sometimes occur. Therefore, to investigate the overall effects of rosuvastatin, including lipid lowering and adverse effects, metabolic profiling was performed using metabolomics and lipidomics after rosuvastatin administration. Specifically, the metabolic profiles between healthy subjects and patients with hyperlipidemia were compared and the metabolic changes related to the mechanism of the drug effect were proposed...
May 28, 2018: Chemistry and Physics of Lipids
Tom Rosenberg, Shmuel Heitner, Dennis Scolnik, Einav Levin Ben-Adiva, Ayelet Rimon, Miguel Glatstein
OBJECTIVE: The aims of the study were to determine the evolution of benign acute childhood myositis in children and to assess the relationship between creatine phosphokinase (CPK) values and myoglobinuria. STUDY DESIGN: A retrospective study of patients with benign acute childhood myositis seen in 2 tertiary care university-affiliated pediatric hospitals during overlapping 4-year periods. METHODS: Demographic data, historical details, clinical, and laboratory results were extracted from the charts of children younger than 16 years with a CPK greater than 3 times normal...
June 2018: Pediatric Emergency Care
Akaolisa S Eziokwu, Dana Angelini
A 24-year-old African-American man presented with malaise and low back pain and was found to have acute severe rhabdomyolysis followed by acute hemolysis. Glucose-6-phosphate dehydrogenase (G6PD) deficiency was suspected by the presence of blister cells on peripheral smear and was confirmed by a low enzyme activity assay. Our patient reported playing football, along with upper respiratory infection symptoms, prior to presentation. Extensive infectious and toxicology workup was negative; however, several inflammatory proteins were markedly elevated...
March 28, 2018: Curēus
Kalyana C Janga, Sheldon Greenberg, Phone Oo, Kavita Sharma, Umair Ahmed
A 26-year-old African American male with a history of congenital cerebral palsy, sickle cell trait, and intellectual disability presented with abdominal pain that started four hours prior to the hospital visit. The patient denied fever, chills, diarrhea, or any localized trauma. The patient was at a party at his community center last evening and danced for 2 hours, physically exerting himself more than usual. Labs revealed blood urea nitrogen (BUN) level of 41 mg/dL and creatinine (Cr) of 2.8 mg/dL which later increased to 4...
2018: Case Reports in Nephrology
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