Immobilization-induced rhabdomyolysis patients with peripheral neuropathy: clinical, laboratory and imaging findings
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Peripheral nerve injury rarely occurs in patients with rhabdomyolysis. Based on our experience and previous reports, we consider prolonged immobilization a risk factor for the development of peripheral neuropathy in rhabdomyolysis patients. Methods: This study analyzed 28 patients with rhabdomyolysis due to prolonged immobilization. We analyzed their demographic and laboratory data, clinical and imaging findings, and outcomes, and compared these factors between patients with and without neuropathy. Results: Seven of the 28 patients had peripheral neuropathy, including sciatic neuropathy or lumbosacral plexopathy. Compared to those without neuropathy, the patients with neuropathy were younger (p = 0.02), had higher peak creatine kinase (CK) levels (p = 0.02), had higher muscle uptake in bone scans (p = 0.03), and more frequently exhibited abnormal muscle findings in computed tomography (CT) (p = 0.004). Conclusions: Patients with prolonged immobilization-induced rhabdomyolysis and neuropathy had higher CK levels, increased uptake on bone scans, and more-frequent abnormal muscles on CT than those without neuropathy. These findings indicate that peripheral neuropathy is more likely to develop in patients with severe muscle injury.
Abstract
Background: Peripheral nerve injury rarely occurs in patients with rhabdomyolysis. Based on our experience and previous reports, we consider prolonged immobilization a risk factor for the development of peripheral neuropathy in rhabdomyolysis patients. Methods: This study analyzed 28 patients with rhabdomyolysis due to prolonged immobilization. We analyzed their demographic and laboratory data, clinical and imaging findings, and outcomes, and compared these factors between patients with and without neuropathy. Results: Seven of the 28 patients had peripheral neuropathy, including sciatic neuropathy or lumbosacral plexopathy. Compared to those without neuropathy, the patients with neuropathy were younger (p = 0.02), had higher peak creatine kinase (CK) levels (p = 0.02), had higher muscle uptake in bone scans (p = 0.03), and more frequently exhibited abnormal muscle findings in computed tomography (CT) (p = 0.004). Conclusions: Patients with prolonged immobilization-induced rhabdomyolysis and neuropathy had higher CK levels, increased uptake on bone scans, and more-frequent abnormal muscles on CT than those without neuropathy. These findings indicate that peripheral neuropathy is more likely to develop in patients with severe muscle injury.
참고문헌 (13)
- Bosch X, "Rhabdomyolysis and acute kidney injury", N Engl J Med, 361, pp.62~72 (2009)
- 석정임, "횡문근융해 환자에서 발생한 말초신경병의급성-아급성기의 임상 특징과 전기진단검사 소견", 대한신경과학회지, 37(1), pp.26~29 (2019), 대한신경과학회[DOI]
- Maddison P, "Acute rhabdomyolysis and brachial plexopathy following alcohol ingestion", Muscle Nerve, 25, pp.283~285 (2002)
- Nicolle M, "Bilateral femoral neuropathy complicating rhabdomyolysis and acute renal failure", J Clin Neuromuscul Dis, 6, pp.153~156 (2005)
- 지정우, "Acute Compartment Syndrome Which Causes Rhabdomyolysis by Carbon Monoxide Poisoning and Sciatic Nerve Injury Associated with It: A Case Report", Hip and Pelvis, 29(3), pp.204~209 (2017), 대한고관절학회[DOI]
- 김인수, "Multiple Peripheral Neuropathies Adjacent to Necrotizing Myositis Related to Rhabdomyolysis", Annals of geriatric medicine and research, 21(1), pp.31~34 (2017), 대한노인병학회[DOI]
- McMahon GM, "A risk prediction score for kidney failure or mortality in rhabdomyolysis", JAMA Intern Med, 173, pp.1821~1828 (2013)
- Hamel Y, "Acute rhabdomyolysis and inflammation", J Inherit Metab Dis, 38, pp.621~628 (2015)
- Feng Q, "Individualized risk for statin-induced myopathy: current knowledge, emerging challenges and potential solutions", Pharmacogenomics, 13, pp.579~594 (2012)
- Knapik JJ, "Exertional rhabdomyolysis: epidemiology, diagnosis, treatment, and prevention", J Spec Oper Med, 16, pp.65~71 (2016)
- Chang HR, "Evaluation of the severity of traumatic rhabdomyolysis using technetium-99m pyrophosphate scintigraphy", Am J Nephrol, 21, pp.208~214 (2001)
- Keltz E, "Rhabdomyolysis. The role of diagnostic and prognostic factors", Muscles Ligaments Tendons J, 3, pp.303~312 (2014)
- Lamminen AE, "Acute rhabdomyolysis : evaluation with magnetic resonance imaging compared with computed tomography and ultrasonography", Br J Radiol, 62, pp.326~330 (1989)