Rhabdomyolysis of Infectious Etiology with Creatine Kinase Above One Million: A Case Report.

Abstract

BACKGROUND Rhabdomyolysis occurs commonly in hospitalized patients due to many etiologies. It is characterized by elevated creatine kinase, weakness, and myalgias, with severe forms causing electrolyte imbalances. However, many of these patients have a mild disease course with no symptoms. Those with more severe disease often have associated acute kidney injury. When acute kidney injury occurs solely due to rhabdomyolysis, it is unlikely to cause the patient to require renal replacement therapy. Regardless of how common this disease is, little research has been done to determine prognosticating factors for renal recovery in the patients who do require renal replacement therapy. CASE REPORT We present the case a young patient who developed severe kidney damage from rhabdomyolysis, requiring renal replacement, and who had renal recovery in a relatively short time. Our patient's maximum creatine kinase was 1 353 105 IU/L. Yet regardless of this severe elevation, his kidneys showed full recovery in under 3 weeks. CONCLUSIONS We present a case of a patient with rhabdomyolysis and CK above one million. In our literature review, we found that exertion and genetic defects were found to cause CK elevations above one hundred thousand, but infection is perhaps the most common cause of such extreme elevations. Regardless of how high CK is, there are no consistent factors reported in the literature correlating with degree of and rate of renal recovery in these patients.