Acute kidney injury due to rhabdomyolysis after status epilepticus: Two pediatric case reports

Abstract

Rhabdomyolysis is defined as degeneration of skeletal muscle due to traumatic or non-traumatic causes. With the injury of sarcolemma, myocyte contents (myoglobin, enzymes and electrolytes) leakage into the plasma and urine occurs. If rhabdomyolysis is not recognized and untreated, severe even fatal complications such as acute kidney injury (AKI), hypocalcemia, hyperkalemia, hypovolemia, muscle necrosis, cardiac arrythmias and compartment syndrome may occur. Status epilepticus is an uncommon cause of rhabdomyolysis and myoglobinuria. We report here two pediatric patients, who developed myoglobinuria and AKI due to status epilepticus. J Clin Exp Invest 2013; 4 (4): 517-520

Keywords

• Epilepsy, child, rhabdomyolysis, kidney injury

Acute kidney injury due to rhabdomyolysis after status epilepticus: Two pediatric case reports

Öz

Rabdomiyoliz, travmatik veya non-travmatik sebeplerle çizgili kas hücrelerinin hasara uğramasıdır. Hasar sonrası kas hücre içeriği (miyoglobin, enzim ve elektrolitler) dolaşıma katılır. Rabdomiyoliz teşhis ve tedavi edilmezse akut böbrek hasarı (ABH), hipokalsemi, hiperkalemi, hipovolemi, kas nekrozu, kardiyak aritmi ve kompartman sendromu gibi ciddi komplikasyonlara neden olabilir. Status epileptikus, rabdomiyoliz ve miyoglobinürinin nadir sebeplerindendir. Bu yazıda status epileptikus sonrası miyoglobinüri ve ABH gelişen iki pediatrik olgu sunulmuştur.

Anahtar Kelimeler

• Epilepsi, çocuk, rabdomiyoliz, böbrek hasarı

Kaynakça

1. Khan FY. Rhabdomyolysis: a review of the literature. Neth J Med 2009;67:272-283.
2. Hojs R, Ekart R, Sinkovic A, Hojs-Fabjan T. Rhabdo- myolysis and acute renal failure in intensive care unit. Ren Fail 1999;21:675-684.
3. Holt S, Moore K. Pathogenesis of renal failure in rhabdomyolysis: the role of myoglobin. Exp Nephrol 2000;8:72-76.
4. El-Abdellati E, Eyselbergs M, Sirimsi H, et al. An obser- vational study on rhabdomyolysis in the intensive care unit. Exploring its risk factors and main complication: acute kidney injury. Ann Intensive Care 2013;3:8 doi: 10.1186/2110-5820-3-8.
5. Mattana J, Singhal PC. Determinants of elevated cre- atine kinase activity and creatine kinase MB-frac- tion following cardiopulmonary resuscitation. Chest 1992;101:1386-1392.
6. Huerta-Alardín AL, Varon J, Marik PE Bench-to-bed- side review: Rhabdomyolysis -- an overview for clini- cians. Crit Care 2005;9:158-169.
7. Gabow PA, Kaehny WD, Kelleher SP. The spectrum of rhabdomyolysis. Medicine 1982;61:141-152.
8. Al-Ismaili Z, Piccioni M, Zappitelli M. Rhabdomyolysis: pathogenesis of renal injury and management. Pedi- atr Nephrol 2011;26:1781-1788.

9. Mannix R, Tan ML, Wright R, Baskin M. Acute pediatric rhabdomyolysis: causes and rates of renal failure. Pe- diatrics 2006;118:2119-2125.
10. Elsayed EF, Reilly RF. Rhabdomyolysis: a review, with emphasis on the pediatric population. Pediatr Nephrol 2010;2:7-18.
11. Kim KK. Exogenous causes of myoglobinuria- review of 26 cases. J Korean Med Sci 1996;11:342-346.