Acute Poisoning-Induced Rhabdomyolysis and Related Complications: A Report of Two Cases

Rhabdomyolysis following acute poisoning is a rare complication. Acute poisoning with profenofos, an organophosphorus insecticide that irreversibly inhibits acetylcholinesterase, and Super Vasmol 33, a hair dye containing para-phenylenediamine, is associated with significant morbidity and mortality. Although rhabdomyolysis is an uncommon complication, it may precipitate acute kidney injury (AKI) and multiorgan dysfunction syndrome (MODS). Here, we report two cases of rhabdomyolysis following acute poisoning. The first case involved a 40-year-old nonalcoholic male admitted after self-ingestion of Profestar 50% E.C. (profenofos 50%). He developed rhabdomyolysis followed by AKI and MODS, requiring multiple hemodialysis sessions and other critical care support. His hospital stay was complicated by a hospital-acquired infection, which improved with antibiotic therapy. The second case involved a 15-year-old female with Super Vasmol 33 poisoning who developed neck edema and stridor, which improved after administration of epinephrine and hydrocortisone. Subsequently, she developed rhabdomyolysis and MODS, requiring dialysis. Both patients fully recovered and were discharged. Despite severe poisoning, both patients had favorable outcomes due to early recognition of rhabdomyolysis, prompt aggressive fluid resuscitation, timely renal replacement therapy, intensive care support, early airway management in the Super Vasmol poisoning case, and close monitoring with correction of metabolic and electrolyte abnormalities, resulting in complete recovery.