Drug-induced rhabdomyolysis

Drug-induced rhabdomyolysis is a common syndrome that is complex and potentially life threatening. This article reviews the pathophysiology, clinical presentations, and common compounds that cause drug-induced rhabdomyolysis.

The list of drugs and inciting agents that cause rhabdomyolysis is quite extensive. Rhabdomyolysis is defined as skeletal muscle injury that leads to the lysis of muscle cells and the leakage of myocyte contents into the extracellular compartments. The presenting clinical features are myalgias, myoglobinuria, and an elevated serum creatine kinase. There have been several case reports in the literature involving some common pediatric drugs that are associated with rhabdomyolysis. Diphenhydramine, Ecstasy, and baclofen have recently been implicated as the etiology of drug-induced rhabdomyolysis in several pediatric patients. Alkalinization of the urine is a controversial treatment of drug-induced rhabdomyolysis and has proven to be beneficial in some patients.

A high index of suspicion, early recognition, and adequate treatment will result in an excellent prognosis of drug-induced rhabdomyolysis.