Child Kidney Dis.  2018 Oct;22(2):52-57. 10.3339/jkspn.2018.22.2.52.

Clinical Characteristics of Rhabdomyolysis in Children : Single Center Experience

• Park Y
• Song JY
• Kim SY
• Kim SH

• KMID: 2435370
• DOI: http://doi.org/10.3339/jkspn.2018.22.2.52

Abstract

PURPOSE
Rhabdomyolysis is a metabolic disorder in which the content of damaged muscle cells is released into plasma. Its manifestations include asymptomatic, myalgia, gross hematuria, and complications of acute kidney injury. Because of limited data on rhabdomyolysis in children, we performed this study to determine clinical characteristics of rhabdomyolysis in children.
METHODS
We retrospectively reviewed the records of patients with rhabdomyolysis who were treated at the Pusan National University Children's hospital from January 2011 to July 2016. The diagnostic criteria were serum myoglobin level of ≥80 ng/mL, exclusive of acute myocardial injury, cardiac arrest, and brain damage.
RESULTS
Forty-five patients were enrolled; mean age, 116±68 months. Of these, 35 were boys and 10 were girls. Twenty-six patients experienced myalgia and 12 patients showed gross hematuria. Among these, seven patients initially had both myalgia and gross hematuria. The most common causes of rhabdomyolysis were infection, physical exertion, prolonged seizures, metabolic abnormalities, and drug addiction. Acute kidney injury (AKI) was the most common complication, followed by disseminated intravascular coagulation. Thirty-seven patients improved with sufficient fluid supply but two patients underwent hemodialysis due to deterioration of kidney function. Gross hematuria, positive occult blood test, and positive urine protein were more common in patients with AKI than in those without AKI.
CONCLUSIONS
In children, infection was the most common cause of rhabdomyolysis. Most patients recovered by sufficient fluid therapy. However, in severe cases, especially in patients with underlying kidney disease, hemodialysis may be necessary in the present study.

Keyword

Rhabdomyolysis; Influenza; Physical exertion; Acute kidney injury; Children

MeSH Terms

Acute Kidney Injury
Brain
Busan
Child*
Disseminated Intravascular Coagulation
Female
Fluid Therapy
Heart Arrest
Hematuria
Humans
Influenza, Human
Kidney
Kidney Diseases
Muscle Cells
Myalgia
Myoglobin
Occult Blood
Physical Exertion
Plasma
Renal Dialysis
Retrospective Studies
Rhabdomyolysis*
Seizures
Substance-Related Disorders
Myoglobin