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Reversible hepatic dysfunction associated with rhabdomyolysis.

M Akmal1, S G Massry

  • 1Division of Nephrology, University of Southern California School of Medicine, Los Angeles.

American Journal of Nephrology
|January 1, 1990
PubMed
Summary

Nontraumatic rhabdomyolysis can cause liver dysfunction in about 25% of patients, marked by elevated liver enzymes. These hepatic derangements are reversible and may be multifactorial.

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Area of Science:

  • Nephrology
  • Hepatology
  • Internal Medicine

Background:

  • Rhabdomyolysis, a skeletal muscle breakdown syndrome, can lead to systemic complications.
  • Hepatic dysfunction is a recognized, though not fully understood, complication of rhabdomyolysis.

Purpose of the Study:

  • To investigate the prevalence and characteristics of hepatic dysfunction in patients with nontraumatic rhabdomyolysis.
  • To compare the incidence and severity of liver abnormalities in patients with and without acute renal failure (ARF).

Main Methods:

  • Retrospective analysis of 34 patients with nontraumatic rhabdomyolysis.
  • Assessment of serum liver enzymes (LDH, ALT, AST), bilirubin levels, and prothrombin time.
  • Comparison of laboratory values between patients with and without ARF.

Main Results:

  • Elevated lactic dehydrogenase (LDH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were observed in all patients within 72 hours of hospitalization.
  • ALT and AST levels were significantly higher in patients with ARF compared to those without.
  • Hyperbilirubinemia and prolonged prothrombin time occurred in a significant proportion of patients, with similar magnitude and duration in both ARF and non-ARF groups.

Conclusions:

  • Hepatic dysfunction occurs in approximately 25% of patients with rhabdomyolysis.
  • The exact pathogenesis is multifactorial, potentially involving hyperpyrexia, hypotension, and muscle-derived proteases.
  • Observed hepatic derangements are generally reversible.

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