Rhabdomyolysis and acute renal failure after intense physical activity

A 23-year-old male was admitted to the emergency department with complaint of worsening lower limbs pain since a few hours ago. No history of recent trauma was noted. He was healthy overall, and his past medical history was unremarkable. On examination the patient was agitated because of pain and mildly dehydrated. His blood pressure was 115/65 mm Hg, pulse rate 106/min, respiratory rate 24/min, and temperature 37.1°C. Evaluation of lower limbs revealed only mild tender and tense calves. No difference between temperature and size of legs was detected. Sensory and motor exam of four limbs was normal.