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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Induction and Assessment of Exertional Skeletal Muscle Damage in Humans
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Rash and elevated creatine kinase in a deployed soldier.

Thomas W Schmidt1, Mark Garfinkle2, Daniel F Battafarano1

  • 1Department of Rheumatology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234-6272.

Military Medicine
|February 5, 2014
PubMed
Summary

A soldier

Area of Science:

  • Infectious Diseases
  • Dermatology
  • Rheumatology

Background:

  • A 24-year-old active duty soldier presented with persistent upper respiratory tract infection.
  • The patient developed an exfoliative rash, myalgia, and elevated creatine kinase after trimethoprim-sulfamethoxazole exposure.

Observation:

  • The patient's symptoms persisted despite medication withdrawal, mimicking dermatomyositis.
  • A muscle biopsy was negative for dermatomyositis.
  • Serological tests were positive for acute Epstein-Barr virus infection.

Findings:

  • The case highlights a potential diagnostic challenge in differentiating drug reactions from viral infections.
  • Acute Epstein-Barr virus infection can present with symptoms that overlap with autoimmune conditions.

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  • Trimethoprim-sulfamethoxazole may trigger reactions that mimic inflammatory myopathies.

    • Implications:

    • This case underscores the importance of considering viral etiologies in patients with unexplained myositis and rash.
    • Clinicians should be aware of the potential for trimethoprim-sulfamethoxazole to cause dermatomyositis-like syndromes.
    • Further investigation into the immunopathogenesis of Epstein-Barr virus-associated myopathy is warranted.