• CytoSorb
• SLEDD
• intensive care unit
• monacolin K
• over-the-counter medications
• red yeast rice
• rhabdomyolysis

• funding

• Crush syndrome
• Disaster medicine
• Earthquakes
• Mortality
• Orthopedics
• Renal replacement therapy

• Humans
• Earthquakes
• Female
• Retrospective Studies
• Male
• Adult
• Renal Dialysis/statistics & numerical data
• Middle Aged
• Crush Syndrome/mortality
• Postoperative Complications/mortality
• Postoperative Complications/epidemiology
• Aged
• Young Adult

• Postreperfusion syndrome
• forelimb ischemia
• preclinical model
• rhabdomyolysis
• skeletal muscle reperfusion

• T32 AR056950 NIAMS NIH HHS

• creatine kinase
• kidney injury
• liver enzymes
• pediatrics
• rhabdomyolysis

• Hypokalemia
• Literature analysis
• Primary aldosteronism
• Rhabdomyolysis

• Humans
• Male
• Rhabdomyolysis/etiology
• Rhabdomyolysis/complications
• Rhabdomyolysis/diagnosis
• Middle Aged
• Hyperaldosteronism/complications
• Hyperaldosteronism/diagnosis
• Hypokalemia/etiology
• Hypokalemia/diagnosis
• Diagnosis, Differential
• Potassium/blood
• Potassium/therapeutic use

• 11-epoxide
• Adult population
• Carbamazepine
• Carbamazepine-10
• NONMEM
• poisoning
• population toxicokinetics

• acute renal injury
• anaphylaxis
• compartment syndrome
• insect bite complications
• intravenous hydration
• multiple wasp stings
• myoglobinuria
• rhabdomyolysis
• toxic systemic reactions
• wasp sting

• Humans
• Germany/epidemiology
• Female
• Male
• Middle Aged
• Aged
• Tertiary Care Centers/statistics & numerical data
• Liver Function Tests
• Hospital Mortality
• Adult
• Liver Diseases/diagnosis
• Liver Diseases/blood
• Liver Diseases/mortality
• Alanine Transaminase/blood
• Aspartate Aminotransferases/blood
• Liver/enzymology
• Liver/pathology
• Internal Medicine

• Hepatitis A
• complications
• rhabdomyolysis

• Black cohosh
• Herbal supplements
• Rhabdomyolysis
• Serotonin toxicity

• Humans
• Female
• Rhabdomyolysis/chemically induced
• Cimicifuga/adverse effects
• Middle Aged
• Serotonin Syndrome/chemically induced
• Serotonin
• Herb-Drug Interactions
• Antidepressive Agents/adverse effects
• Prescription Drugs/adverse effects
• Emergency Service, Hospital/organization & administration

• creatine
• foot drop
• hematology
• hemodialysis
• myoglubineuria
• pre-workout
• protein supplements
• renal failure
• rhabdomyolysis
• supplemental toxicity

• case report
• laboratory markers
• military personnel
• military training
• rhabdomyolysis

• Humans
• Military Personnel
• Rhabdomyolysis/epidemiology
• Rhabdomyolysis/etiology
• Rhabdomyolysis/diagnosis
• Exercise/physiology
• Risk Factors
• Creatine Kinase
• Biomarkers

• Anion gap
• Catabolism
• Hyperammonemia
• Inborn error of metabolism
• Ketone
• Lactate
• Metabolic acidosis
• Sodium phenylbutyrate

• Humans
• Nutritional Status
• Ammonia
• Keto Acids
• Lactic Acid

• Acute kidney injury
• Creatine kinase
• Free T3
• Hypothyroidism

• Female
• Humans
• Male
• Acute Kidney Injury/epidemiology
• Acute Kidney Injury/etiology
• Creatinine
• Prognosis
• Prospective Studies
• Retrospective Studies
• Rhabdomyolysis/epidemiology
• Rhabdomyolysis/etiology
• Rhabdomyolysis/therapy
• ROC Curve
• Adult
• Middle Aged
• Aged

• biomarker
• crush injury
• crush syndrome
• diagnosis
• predictive evaluation

• clinical trials
• coenzyme Q10
• liver enzymes
• meta‐analysis

• Acute liver injury
• Adverse drug reaction
• Diclofenac
• Drug-induced liver injury
• Hepatotoxicity
• Non-steroidal anti-inflammatory drugs
• Topical

• Dialysis
• Drugs and medicines
• Psychiatry
• Renal system
• Unwanted effects / adverse reactions

• Humans
• Olanzapine/therapeutic use
• Benzodiazepines/therapeutic use
• Antipsychotic Agents/adverse effects
• Schizophrenia/drug therapy
• Neuroleptic Malignant Syndrome/drug therapy
• Rhabdomyolysis/complications

• anaesthesia
• cardiac complications
• critical care
• emergency card
• neuromuscular diseases
• respiratory complications
• swallowing difficulties

• acute myocardial infarction
• elevated aspartate aminotransferase
• etiology
• hemolysis
• rhabdomyolysis

• beta-oxidation
• heptanoate
• long-chain fatty acid oxidation disorders (LC-FAOD)
• population pharmacokinetics
• triheptanoin

Magnetic hyperthermia is a promising therapy for the treatment of certain types of tumors. However, it is not clear what the maximum limit of the magnetic field to which the organism can be subjected without severe and/or irreversible pathophysiological consequences is. This study aims to study the alterations at the physiological level that may occur after exposure to different combinations of frequency and intensity of the applied alternating magnetic field. Understanding the response to alternating magnetic field exposure will allow us to apply this type of antitumor treatment in a safer way for the patient, while achieving an optimal therapeutic result.

Background: Lately, major advances in crucial aspects of magnetic hyperthermia (MH) therapy have been made (nanoparticle synthesis, biosafety, etc.). However, there is one key point still lacking improvement: the magnetic field-frequency product (H × f = 4.85 × 10⁸ Am⁻¹s⁻¹) proposed by Atkinson–Brezovich as a limit for MH therapies. Herein, we analyze both local and systemic physiological effects of overpassing this limit. Methods: Different combinations of field frequency and intensity exceeding the Atkinson–Brezovich limit (591–920 kHz, and 10.3–18 kA/m) have been applied for 21 min to WAG/RijHsd male rats, randomly distributed to groups of 12 animals; half of them were sacrificed after 12 h, and the others 10 days later. Biochemical serum analyses were performed to assess the general, hepatic, renal and/or pancreatic function. Results: MH raised liver temperature to 42.8 ± 0.4 °C. Although in five of the groups the exposure was relatively well tolerated, in the two of highest frequency (928 kHz) and intensity (18 kA/m), more than 50% of the animals died. A striking elevation in liver and systemic markers was observed after 12 h in the surviving animals, independently of the frequency and intensity used. Ten days later, liver markers were almost recovered in all of the animals. However, in those groups exposed to 591 kHz and 16 kA/m, and 700 kHz and 13.7 kA/m systemic markers remained altered. Conclusions: Exceeding the Atkinson–Brezovich limit up to 9.59 × 10⁹ Am⁻¹s⁻¹ seems to be safe, though further research is needed to understand the impact of intensity and/or frequency on physiological conditions following MH.

Acne vulgaris is one of the most common skin conditions treated by healthcare providers. Isotretinoin is a well-known and effective treatment for nodulocystic and scarring acne. Rarely, and usually in combination with exercise, patients treated with isotretinoin can develop rhabdomyolysis, a potentially life-threatening breakdown of muscle associated with elevated creatine kinase (CK). Here, we report a rare case of a female patient developing rhabdomyolysis three months after starting exercise and isotretinoin. She was treated with supportive care and medication was discontinued, resulting in a full recovery. Careful inquiry into the patient's exercise habits, along with a thorough review of systems at each visit can help identify high-risk patients. Routine monitoring of liver enzymes, specifically aspartate aminotransferase elevations, may provide a prompt to check a patient’s CK. Though regular monitoring of CK is not currently recommended, given the prevalence of regular exercise in certain patient populations, this case reinforces the importance of counseling patients on this potential side effect.

• Hypoxic hepatitis
• aminotransferase levels
• etiology
• intensive care unit
• ischemic hepatitis
• liver disease
• outcomes
• shock liver

• Diagnosis
• Diagnostic delay
• Dystroglycanopathy
• FKRP
• Limb-girdle muscular dystrophy
• Weakness

• Adolescent
• Adult
• Aged
• Child
• Delayed Diagnosis
• Female
• Humans
• Male
• Middle Aged
• Muscle Weakness/etiology
• Muscle Weakness/physiopathology
• Muscular Dystrophies/complications
• Muscular Dystrophies/diagnosis
• Muscular Dystrophies/genetics
• Muscular Dystrophies/physiopathology
• Myoglobinuria/etiology
• Pentosyltransferases/genetics
• Young Adult

• UH3 AR076387 NIAMS NIH HHS
• UL1 TR002537 NCATS NIH HHS
• UG3 AR076387 NIAMS NIH HHS
• U54 NS053672 NINDS NIH HHS
• R01 NR017610 NINR NIH HHS
• P50 NS053672 NINDS NIH HHS
• R01 AR077418 NIAMS NIH HHS
• R01 HL153095 NHLBI NIH HHS
• R01 CA193249 NCI NIH HHS
• R01 CA246540 NCI NIH HHS

Rhabdomyolysis is defined as a syndrome consisting of muscle necrosis and the release of intracellular muscle components into the bloodstream. Although rhabdomyolysis has been previously reported as an initial presentation or late complication of COVID-19, the data on it is still limited, and currently, there is no single case of COVID-19 in the literature that describes creatine kinase levels of more than 30,000 IU/L.

A 50-year-old African–American male presented to the hospital with decreased urine output, dark urine color, and constipation for the past couple of days. He was found to have acute kidney injury, liver injury, and creatinine kinase of 359,910 IU/L, for which aggressive intravenous fluid therapy was given. Infectious workup resulted in positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction. Two days after admission, the patient became symptomatic from a coronavirus disease 2019: he developed fever and hypoxia, and was placed on supplemental oxygen and started on a 10-day course of dexamethasone. The patient responded well to the treatment and supportive care for coronavirus disease 2019 and was successfully discharged.

Clinicians should be cognizant of atypical coronavirus disease 2019 presentations. The spectrum of damage of coronavirus disease 2019 is still an evolving topic, and more research is required to reveal the exact mechanisms by which severe acute respiratory syndrome coronavirus 2 leads to rhabdomyolysis.

• COVID-19
• Coronavirus
• Creatine kinase
• Rhabdomyolysis
• SARS-CoV-2

SARS-CoV-2 entered the world by storm when it made its appearance at the end of 2019 in Wuhan, China. The severity can range from asymptomatic infection, which occurs in approximately 33% of infected patients, to death. Worldwide deaths due to SARS-CoV-2 are currently approximated at 3.8 million people with close to 600,000 deaths in the United States alone, reiterating the significant impact this virus has on the population. SARS-CoV-2 can affect systems of the body such as respiratory, gastrointestinal tract, neurological, cardiac, renal, and even skeletal muscle tissue. A few cases of rhabdomyolysis are reported in SARS-CoV-2 infection, but the significant level of creatinine kinase in the hundreds of thousands is rare. Our case demonstrates the rarity of SARS-CoV-2 manifestation in a 33-year-old African American male with severe rhabdomyolysis with a creatinine kinase on the admission of 362,445 IU/L. The patient was treated aggressively with intravenous fluids, monitoring electrolytes, renal function, and respiratory status closely. His management includes liberal administration of fluid to treat his rhabdomyolysis, without compromising his respiratory status. He was subsequently discharged home after seven days of hospitalization. We strive to share this information in hopes to share our management for future similar cases.

• covid-19
• hepatocellular injury
• rare disease
• rhabdomyolysis
• sars-2-coronavirus

• AST
• aspartate aminotransferase
• cinnamon
• liver function
• meta-analysis

• Carnitine palmitoyltransferase-II deficiency
• myopathy
• rhabdomyolysis

• Acute Kidney Injury
• Central Nervous System Viral Diseases
• Child
• Compartment Syndromes
• Female
• Humans
• Muscle, Skeletal
• Myelitis
• Neuromuscular Diseases
• Paralysis/etiology
• Rhabdomyolysis/diagnosis
• Rhabdomyolysis/etiology

Adenovirus is a common cause of upper respiratory and gastrointestinal tract infections. Though cases of significant organ failure and death have been reported in young children and immunocompromised individuals, adenovirus infections in healthy individuals are typically self-limiting without significant morbidity or mortality. Exertional rhabdomyolysis is a pathologic condition resulting from repetitive, excessive, or prolonged exercise, often in a hot environment, leading to acute muscle injury, renal injury and, rarely, death. We report a case of adenovirus infection leading to acute liver failure complicated by rhabdomyolysis in a collegiate football player presenting with nausea, vomiting, and diarrhea. We propose a protocol to safely guide the return to play progression for patients with complicated exertional rhabdomyolysis.

• adenovirus
• american football
• exertional rhabdomyolysis
• liver failure
• sports medicine

• Budd Chiari syndrome
• Doppler
• ECMO
• transaminitis
• ultrasound

There is increased interest in the therapeutic use of statins in cirrhosis, but preferred statin and safety outcomes are still not well known. In this systematic review we aimed to address pharmacokinetics (PK), safety, and effects on cardiovascular (CV) outcomes of statins in cirrhosis.

Our systematic search in several electronic databases and repositories of two regulatory bodies up to 2020-06-11 yielded 22 articles and 2 drug monographs with relevant data.

Rosuvastatin and pitavastatin showed minimal PK changes in Child–Pugh A cirrhosis. Only rosuvastatin was assessed in a repeated dosing PK study. Atorvastatin showed pronounced PK changes in cirrhosis. No PK data was found for simvastatin, the most commonly used statin in cirrhosis trials. There was insufficient data to assess CV effects of statins in cirrhosis. Clinical trials in cirrhosis were limited to simvastatin, atorvastatin, and pravastatin. In patients taking simvastatin 40 mg, pooled frequency of rhabdomyolysis was 2%, an incidence 40-fold higher than that reported in non-cirrhosis patients, while this was no rhabdomyolysis observed in patients on simvastatin 20 mg, atorvastatin 20 mg, or pravastatin 40 mg. Drug-induced liver injury was of difficult interpretation due to co-existence of muscle damage. No overt liver failure was reported.

Simvastatin 40 mg should be avoided in decompensated cirrhosis. Safety data on simvastatin 20 mg or other statins are based on small study sample size. This rarity of evidence combined with lack of data in dose adjustment methods in cirrhosis is a barrier for using statins for CV indications or for investigational use for liver indications.

The online version contains supplementary material available at 10.1186/s12876-021-01704-w.

• Drug induced liver injury
• Hepatic
• Liver
• Myalgia
• Portal hypertension
• Rhabdomyolysis

• Burn
• De Ritis ratio
• Mortality

• Case Report
• Percussion Massage Gun
• Percussive Therapy
• Rhabdomyolysis
• Trauma

• Adult
• Anemia, Iron-Deficiency/complications
• Female
• Humans
• Massage/adverse effects
• Massage/instrumentation
• Percussion
• Rhabdomyolysis/etiology
• Rhabdomyolysis/therapy

• Li Ka Shing Foundation Cross-Disciplinary Research

• Russula species
• cardiovascular effects
• deaths
• mushroom poisoning
• rhabdomyolysis

Terbinafine is an antimicrobial agent commonly prescribed for fungal infections. Its side effect profile is generally benign, but there is limited evidence that it has the potential to cause rhabdomyolysis. Rhabdomyolysis is a potentially life-threatening condition caused by profound muscle injury. It has characteristic findings of muscle pain, weakness, and dark urine. When recognized early, patients with rhabdomyolysis can be managed conservatively with hydration and watchful monitoring. However, if treatments are delayed, or in severe cases of rhabdomyolysis, complications such as electrolyte abnormalities, acute kidney injury, and disseminated intravascular coagulation can develop.

A previously healthy 22-year-old male presented with nausea, vomiting, and dark urine after taking terbinafine 250 mg daily for a tinea infection for 9 days. He developed severe rhabdomyolysis with a serum creatine kinase (CK) of >100 000 U/L as well as anuric acute kidney injury.

The clinical history combined with the diagnostic findings suggest acute kidney injury and rhabdomyolysis associated with terbinafine use.

Terbinafine use was stopped immediately. The patient was started on intravenous fluids and bicarbonate drip. Hemodialysis was initiated to prevent further complications. After his CK level decreased and his clinical status stabilized, he was discharged home and continued to receive outpatient hemodialysis treatments.

The patient’s kidney function returned to baseline after 1 month of outpatient hemodialysis treatments.

In this report, we present a case of rhabdomyolysis associated with terbinafine use that progressed to acute kidney injury requiring dialysis. Our case highlights a less known and severe side effect of this medication and emphasizes the importance of early recognition and treatment of rhabdomyolysis.

• acute kidney injury
• hemodialysis
• rhabdomyolysis
• terbinafine

• Myotoxicity
• antivenom
• elapid
• envenoming
• rhabdomyolysis
• snake
• snakebite
• toxin

• Alkaline phosphatase
• C-reactive protein
• CEW
• Electrical weapon
• Lactate dehydrogenase
• Myoglobin
• Rhabdomyolysis
• Taser®

• atorvastatin
• rhabdomyolysis
• statin

• COVID-19
• Myositis
• Rhabdomyolysis