Clinical communication| Volume 14, ISSUE 4, P425-428, July 1996

Severe rhabdomyolysis following a viral illness: A case report and review of the literature

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      Rhabdomyolysis is a syndrome often associated with alcohol and drug abuse. It may also be seen following viral infections, but is a complication not often considered. We report a case of severe rhabdomyolysis following an influenza-like illness. Despite the extreme elevation of creatinine phosphokinase, 230,600 IU/L, this patient did not develop acute renal failure in contrast to most of the previously documented case reports of rhabdomyolysis associated with influenza virus. This case report illustrates the difficulty in predicting which patients are at risk for developing acute renal failure and emphasizes the need for aggressive treatment of any patient, suspected of having rhabdomyolysis.


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        • Gabow PA
        • Kaehny WD
        • Kelleher SP
        The spectrum of rhabdomyolysis.
        Medicine. 1982; 61: 141-152
        • Curry SC
        • Chang D
        • Conner D
        Drug- and toxin-induced rhabdomyolysis.
        Ann Emerg Med. 1989; 18: 1066-1084
        • Milne CJ
        Rhabdomyolysis, myoglobinuria and exercise.
        Sports Med. 1988; 6: 93-106
        • Tonin P
        • Lewis P
        • Servidei S
        • Dimauro S
        Metabolic causes of myoglobinuria.
        Ann Neuro. 1990; 27: 181-185
        • Wakabayashi Y
        • Nakano T
        • Kikuno T
        • Ohwada T
        • Kikawada R
        Massive rhabdomyolysis associated with influenza A infection.
        Int Med (Japan). 1994; 33: 450-453
        • Berry L
        • Braude S
        Influenza A infection with rhabdomyolysis and acute renal failure—a potentially fatal complication.
        Postgrad Med J. 1991; 67: 389-390
        • Foulkes W
        • Rees J
        • Sewry C
        Influenza A and rhabdomyolysis.
        J Infect. 1990; 21: 303-304
        • Christenson JC
        • San Joaquin VH
        Influenza-associated rhabdomyolysis in a child.
        Pediatr Infect Dis J. 1990; 9: 60-61
        • Cunningham E
        • Kohli R
        • Venuto RC
        Influenza-associated myoglobinuric renal failure.
        JAMA. 1979; 242: 2428-2429
        • DiBona FJ
        • Morens DM
        Rhabdomyolysis associated with influenza A.
        J Pediatr. 1977; 91: 943-945
        • Shenouda A
        • Hatch FE
        Influenza A viral infection associated with acute renal failure.
        Am J Med. 1976; 61: 697-702
        • Morgensen JL
        Myoglobinuria and renal failure associated with influenza.
        Ann Intern Med. 1974; 80: 362-363
        • Minow RA
        • Gorbach S
        • Johnson B
        • Dornfield L
        Myoglobinuria associated with influenza A infection.
        Ann Intern Med. 1974; 80: 359-361
        • Simon NM
        • Rovner RN
        • Berlin BS
        Acute myoglobinuria associated with type A2 (Hong Kong) influenza.
        JAMA. 1970; 212: 1704-1705
        • Paletta CE
        • Lynch R
        • Knutsen AP
        Rhabdomyolysis and lower extremity compartment syndrome due to influenza B virus.
        Ann Plast Surg. 1993; 30: 272-273
        • Knochel JP
        Rhabdomyolysis and myoglobinuria.
        in: 2nd ed. Semin Nephrol. 1. 1981: 75-86
        • Saluzzo RF
        in: Rosen P Barken RM Emergency medicine: concepts and clinical practice. Mosby-Year Book Inc, St. Louis1992: 2232-2241
        • Braun SR
        • Weiss FR
        • Keller AL
        • et al.
        Evaluation of the renal toxicity of heme pigments and their derivatives. A role in the genesis of acute tubular necrosis.
        J Exp Med. 1970; 131: 443-460
        • Bywaters EG
        • Stead JK
        The production of renal failure following injection of solutions containing myohemoglobin.
        L Exp Physiol. 1944; 33: 53
        • Honda N
        • Kurokawa K
        Acute renal failure and rhabdomyolysis.
        Kidney Int. 1983; 23: 888-898
        • Bywaters EG
        • Beall D
        Crush injuries with impairment of renal function.
        Br Med J. 1941; 1: 427-432
        • Ron D
        • Taitelman U
        • Michaelson M
        • et al.
        Prevention of acute renal failure in traumatic rhabdomyolysis.
        Arch Intern Med. 1984; 144: 277-280