Binge alcohol consumption leading to hypokalemic rhabdomyolysis

A 43-year-old man presented with acute onset rapidly progressive weakness in all four limbs (proximal greater than distal), following an episode of binge alcohol ingestion, and was admitted for evaluation and management. There was a history of decreased urine output since 2 days with dark-coloured urine. He was found to have severe hypokalemia and renal dysfunction. Serum creatine kinase was significantly high, and further investigation revealed significantly elevated serum and urine myoglobin levels suggestive of rhabdomyolysis, which was secondary to severe hypokalemia. Following supplementation with intravenous and oral potassium and supportive care, the weakness improved significantly, and he was subsequently discharged. This case describes severe hypokalemia, resulting in rhabdomyolysis and generalised lower motor neuron weakness, in a setting of binge alcohol ingestion, which is an entity rarely described in literature.

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Postoperative changes in serum creatine kinase in paediatric orthopaedic patients with preoperative hyperCKaemia: review of three cases

Southern African Journal of Anaesthesia and Analgesia ◽

10.36303/sajaa.2019.25.3.2187 ◽

2019 ◽

pp. 31-32

Author(s):

S Kira ◽

K Shiihara ◽

K Okuda

Keyword(s):

Creatine Kinase ◽

Orthopaedic Surgery ◽

Reference Range ◽

Elevated Serum ◽

Acute Onset ◽

Serum Creatine Kinase ◽

Paediatric Patients ◽

Postoperative Changes ◽

Orthopaedic Patients ◽

Paediatric Orthopaedic

An elevated serum creatine kinase (CK) level is commonly known as hyperCKaemia, and anaesthesiologists must take into account the potential susceptibility of hyperCKaemia patients to develop malignant hyperthermia during general anaesthesia as well as acute onset of rhabdomyolysis postoperatively. Three paediatric patients with hyperCKaemia were scheduled for orthopaedic surgery. With the consent of their parents, their CK changes were monitored for seven days postoperatively to detect rhabdomyolysis. The results showed that the postoperative CK change patterns were almost the same as those for patients whose CK levels were within reference range. Maximum CK levels tended to be higher in these patients than in the CK reference-range patients studied previously, although the reason remains unclear. This experience and previous studies suggest that measuring CK levels at least on postoperative days 1 and 2 might be better for detecting early signs of rhabdomyolysis, even in paediatric patients with hyperCKaemia.

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Elevated Serum Creatine Kinase Level in Rotavirus Gastroenteritis

Korean Journal of Pediatric Gastroenterology and Nutrition ◽

10.5223/kjpgn.2005.8.2.117 ◽

2005 ◽

Vol 8 (2) ◽

pp. 117 ◽

Cited By ~ 1

Author(s):

Won Tae Bae ◽

Jae Hui Kim ◽

Eun Sil Park ◽

Ji Hyun Seo ◽

Jae Young Lim ◽

...

Keyword(s):

Creatine Kinase ◽

Creatine Kinase Level ◽

Elevated Serum ◽

Serum Creatine Kinase ◽

Rotavirus Gastroenteritis ◽

Serum Creatine Kinase Level

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A Boy with Large Muscles, Leg Pain, and Elevated Serum Creatine Kinase

Neuromuscular Case Studies ◽

10.1016/b978-0-7506-7332-7.50083-0 ◽

2008 ◽

pp. 472-479

Author(s):

Tulio E. Bertorini

Keyword(s):

Creatine Kinase ◽

Elevated Serum ◽

Serum Creatine Kinase ◽

Leg Pain

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Elevated serum creatine kinase levels in psychiatric practice: differential diagnosis and clinical significance: A brief, practical guideline for clinicians

International Journal of Psychiatry in Clinical Practice ◽

10.1080/13651500701784930 ◽

2008 ◽

Vol 12 (2) ◽

pp. 147-150 ◽

Cited By ~ 7

Author(s):

Viktor Voros ◽

Peter Osvath ◽

Sandor Fekete ◽

Tamas Tenyi

Keyword(s):

Creatine Kinase ◽

Differential Diagnosis ◽

Clinical Significance ◽

Elevated Serum ◽

Serum Creatine Kinase ◽

Psychiatric Practice ◽

Practical Guideline

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A Man with Muscle Spasms and Elevated Serum Creatine Kinase

Neuromuscular Case Studies ◽

10.1016/b978-0-7506-7332-7.50043-x ◽

2008 ◽

pp. 255-260

Author(s):

Tulio E. Bertorini

Keyword(s):

Creatine Kinase ◽

Elevated Serum ◽

Serum Creatine Kinase ◽

Muscle Spasms

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Sudden Cardiac Arrest during Adenotonsillectomy in a Patient with Subclinical Duchenne's Muscular Dystrophy

Ear Nose & Throat Journal ◽

10.1177/014556139307200206 ◽

1993 ◽

Vol 72 (2) ◽

pp. 130-131 ◽

Cited By ~ 8

Author(s):

Nick C. Benton ◽

Robert A. Wolgat

Keyword(s):

Cardiac Arrest ◽

Muscular Dystrophy ◽

General Anesthesia ◽

Case Reports ◽

Sudden Cardiac Arrest ◽

Elevated Serum ◽

Serum Creatine Kinase ◽

Strong Family History ◽

History Of ◽

Duchenne's Muscular Dystrophy

We describe a four-year-old boy of Indian descent who had elective adenotonsillectomy for chronic sore throat and partial airway obstruction. About 10 minutes into the procedure, the patient suddenly developed cardiac asystole. After prolonged cardiac resuscitation, recovery was achieved. No permanent neurologic deficits resulted. The child was later found to have a strong family history of Duchenne's muscular dystrophy (DMD) and an elevated serum creatine kinase level documented since shortly after birth. We reviewed several case reports substantiating the risk for cardiac arrest during general anesthesia in DMD patients, and we concluded that DMD is a little-known risk for cardiac arrest during general anesthesia. The otolaryngologist must be aware of this potential complication, because tonsillectomy and adenoidectomy are commonly indicated for children at an age when DMD may be subclinical.

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