A Case of Acute Renal Failure Caused by Amphetamine-Associated Rhabdomyolysis

Kim, Tae Hyung; Kim, Hyoung Wan; Kim, Bong Ryong; Kim, Joon Wan; Park, Jeong Jin; Sohn, In; Cho, Yun Sook

Abstract

Amphetamine toxicity is well known in western countries since several decades ago. Taken in excessive amount, amphetamine causes systemic symptoms such as hyperpyrexia, tachycardia, hyperkinesia, delirium, seizure and circulatory collapse. Acute renal failure following amphetamine ingestion is caused by the direct toxicity of the drug, circulatory collapse, coagulopathy, retroperitoneal hematoma or tubular obstruction by rhabdomyolysis. This is a case of a amphetamine intoxicated 41-year male patient presenting with features of acute renal failure, which is not accompanied by circulatory collapse, nor by coagulopathy. Muscle enzymes and bone scan findings were compatible with nontraumatic muscle injuries, and the renal pathology was tubular necrosis with specific myoglobin casts. Therefore a drug induced rhabdomyolysis causing myoglobinuric tubular injury is highly suspected. The fact that the outcome of the renal disease itself was good despite fatal dosage of this drug is also compatible with myoglobinuric renal failures reported by foreign authors. This is probably the first reported case of acute renal failure caused by amphetamine associated rhabdomyolysis in Korea.