Abstract

TIBADUIZA MOGOLLON, YURIET ALEXANDRA. RHABDOMYOLYSIS AT THE FIRST WEEK OF TRAINING. TWO CASES REPORT. rev.fac.med [online]. 2015, vol.23, n.2, pp.96-109. ISSN 0121-5256.

Rhabdomyolysis is a syndrome caused by breakdown of skeletal muscle with release of muscle cell contents into the bloodstream, may cause lactic acidosis, hyperphosphatemia, disseminated intravascular coagulation, hyperkalemia, compartment syndrome, renal failure, and may even jeopardize the patient's life. The triad of symptoms including myalgia, weakness and urine - chocolate - red color as a cardinal manifestation, against which must be set before the differential diagnosis erythrocyturia apparent and question the use of drugs that turn red urine. Clinical ignorance and delay in diagnosis slow down specific treatment. The diagnosis can be confirmed swiftly demonstrating elevated levels of serum creatine phosphokinase (CPK), metabolic analysis, myoglobinuria, analysis of intracellular glutamic oxaloacetic transaminase/aspartate aminotransferase enzymes (ALT/AST), glutamic pyruvic transaminase/alanine aminotransferase (GPT/ALAT). Treatment is aimed at accelerating recovery, identifying any reversible cause of muscle injury, prevent and treat complications, timely and aggressive crystalloid infusion is the mainstay of treatment, the use of mannitol, bicarbonate and antioxidants even is controversial. This case report shows the typical clinical manifestations of rhabdomyolysis in two men in the first week of training, in whom this condition was precipitated by dehydration, intense physical activity, inadequate clothing and exposure to high ambient temperature (above 25°C). These patients were quickly diagnosed and received timely treatment so no present any complications, actually they are asymptomatic.

Keywords : Rhabdomyolisis; myoglobinuria; dehydration; mialgia; transaminases.

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