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[Rhabdomyolysis in self-induced poisoning. A prospective study]
1Medisinsk avdeling, Ullevål sykehus, Oslo.
Summary
Self-poisoning patients have a high risk of rhabdomyolysis, a condition causing muscle breakdown. Early creatine kinase monitoring in intoxication cases can prevent serious complications like kidney failure.
Area of Science:
- Toxicology
- Nephrology
- Emergency Medicine
Background:
- Self-poisoning is a common reason for hospital admission.
- Rhabdomyolysis, characterized by elevated creatine kinase (CK) levels, is a potential complication of various intoxications.
- Early recognition and management of rhabdomyolysis are crucial to prevent adverse outcomes.
Observation:
- A prospective study assessed 103 hospitalized self-poisoning patients.
- Nearly 7% of patients presented with rhabdomyolysis (CK > 1000 U/l).
- An additional 9.7% had elevated CK levels below the diagnostic threshold for rhabdomyolysis.
Findings:
- Two patients exhibited clinical rhabdomyolysis symptoms upon admission following heroin and salicylate intoxication, respectively.
- Both symptomatic patients developed renal failure, with one requiring peritoneal dialysis.
- The study highlights a significant incidence of rhabdomyolysis in self-poisoning cases.
Implications:
- Creatine kinase level assessment should be standard in all hospitalized intoxication patients.
- Rhabdomyolysis can be asymptomatic, emphasizing the need for routine biochemical screening.
- Prompt identification of rhabdomyolysis allows for timely intervention, potentially mitigating severe complications such as acute kidney injury.