Acute Rhabdomyolysis: A Rare Complication Subsequent to Intrathecal Dose Escalation: A Case Report

Rhabdomyolysis (RM) requires prompt recognition and treatment to prevent serious complications. This case report details RM several months after an intrathecal pump implantation.

A 69-year-old woman with chronic pain syndrome managed by an intrathecal morphine pump presented with worsening proximal lower extremity weakness. Notably, the dose of the intrathecal pain pump was recently increased. Laboratory values revealed elevated creatine kinase (1,678), low potassium (3.2), elevated aspartate aminotransferase (48), lactic acid (2.5), low albumin (2.8), and mild troponin elevation (34). The intrathecal pump was found to be 2 hours behind and was corrected, with its infusion rate reduced by 50%. Potassium replacement improved levels from 3.2 to 3.8 mmol/L. However, mobility remained below baseline, and physical therapy was recommended to improve activity tolerance.

This case report highlights the importance of early recognition and intervention to prevent complications and reduce the mortality of RM.