Exertional Rhabdomyolysis: A Case Report of an Exceptionally Elevated Serum Creatine Kinase (CK) Level

Serum Creatinine Kinase (CK) is used as a diagnostic and prognostic marker in rhabdomyolysis. We present 32-year-old male with exertional rhabdomyolysis following a spin cycling class, with a peak serum CK level of 332,200 U/L. He was admitted for intravenous fluid therapy and then followed-up in the outpatient setting; renal function remained stable throughout. We review the literatures and explain why a combination of patient and environmental factors are important in the pathogenesis of exertional rhabdomyolysis. Despite a markedly elevated level of serum CK, and a correlation between serum CK and the risk of renal dysfunction being well-documented in the literature, normal renal function was noted in our case throughout. Although there is no clear consensus as to whether an elevated serum CK in the absence of renal failure warrants inpatient management, we propose that there could be a cohort of patients who could be managed in the outpatient setting with follow-up.