Rhabdomyolysis in a Civil Aviation Pilot

2020 ◽  
Vol 91 (11) ◽  
pp. 901-903
Author(s):  
Xincheng Liu ◽  
Xingxing Meng ◽  
Chuanyin Zhang ◽  
Jian Chen ◽  
Pengxiang Li ◽  
...  
Keyword(s):  
Case Report ◽  
Kidney Injury ◽  
Medical Intervention ◽  
Lower Limbs ◽  
Civil Aviation ◽  
Early Medical Intervention ◽  
Excessive Exercise ◽  
Lower Limb Muscles ◽  
First Case ◽  
Urine Alkalinization

BACKGROUND: Rhabdomyolysis is a potentially fatal disease caused by trauma, infections, and toxins. Rhabdomyolysis has not been reported in Chinese civil aircrew, but in our case report a male civil copilot contracted rhabdomyolysis after excessive exercise, showing potential for morbidity in pilots.CASE REPORT: After excessive exercise, a 29-yr-old male civil aviation copilot complained of serious myalgia and weakness in lower limb muscles and gross hematuria, whose values of alanine transaminase (ALT), aspartate transaminase (AST), myohemoglobin (Mb), creatine kinase (CK), CK-MB, lactate dehydrogenase (LDH), and -hydroxybutyrate dehydrogenase (-HBDH) were conspicuously increased. Magnetic resonance imaging showed abnormal signal intensities in the lower limbs. The patient was diagnosed with rhabdomyolysis. He was treated with hydration and urine alkalinization. When his condition was stabilized, the patient was discharged. After remaining asymptomatic for 3 mo and getting documentation of normalized lab results, he was granted a first-class medical certificate and returned to work.DISCUSSION: This was the first case of rhabdomyolysis reported in Chinese civil aircrew. Excessive exercise in an overweight pilot may induce rhabdomyolysis. This condition can be controlled and cured by early and effective treatment. Rhabdomyolysis could occur in a population suffering from overweight, obesity, or hyperlipidemia. This case fits in with several other cases of military pilots exercising excessively. The progression could lead to acute kidney injury without prompt and effective intervention. And common symptoms like muscular weakness or myalgia may induce sudden in-flight incapacitation, so early medical intervention should be adopted. Moreover, recurrence of rhabdomyolysis should be considered when resuming flying duties.Liu X, Meng X, Zhang C, Chen J, Li P, Wu X, Fan H. Rhabdomyolysis in a civil aviation pilot. Aerosp Med Hum Res. 2020; 91(11):901903.

scholarly journals The Use of Supra-Hemodiafiltration in Traumatic Rhabdomyolysis and Acute Kidney Injury: A Case Report

2021 ◽  
pp. 26-35
Author(s):  
Gabriele Donati ◽  
Maria Cappuccilli ◽  
Federica Di Filippo ◽  
Simone Nicoletti ◽  
Marco Ruggeri ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Septic Patient ◽  
Medical Therapy ◽  
Kidney Injury ◽  
First Case ◽  
Successful Recovery

Oliguric acute kidney injury due to traumatic rhabdomyolysis can be potentially lethal if the proper medical therapy combined with extracorporeal detoxification is not performed. Different extracorporeal techniques are available to overcome this syndrome. Here, we report the first case of removal of myoglobin and successful recovery from acute kidney injury in an elderly septic patient using supra-hemodiafiltration with endogenous reinfusion technique (HFR-Supra) combined with the medical therapy.

Percutaneous Endoscopic Removal of Cervical Foraminal Schwannoma via Interlaminar Approach: A Case Report

2017 ◽  
Vol 14 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Guang-Yu Ying ◽  
Ying Yao ◽  
Fang Shen ◽  
Zong-Yang Wu ◽  
Chien-Min Chen ◽  
...  
Keyword(s):  
Case Report ◽  
Cervical Vertebrae ◽  
Tumor Resection ◽  
Lower Limbs ◽  
Spinal Nerves ◽  
Postoperative Mri ◽  
Spinal Neoplasm ◽  
Articular Process ◽  
First Case ◽  
Interlaminar Approach

Abstract BACKGROUND AND IMPORTANCE Cervical foraminal schwannomas commonly originate from spinal nerves that pass through the intervertebral foramen of the cervical vertebrae. Because of the proximity of this type of tumor to the vertebral artery and spinal nerves, surgical management remains a major challenge. Conventional open spine surgery usually requires the removal of the articular process and is supplemented by a simultaneous posterolateral spine fusion surgery. To decrease the associated risks of surgical complications by further reducing invasiveness, percutaneous spinal endoscopy may be used for resection of foraminal spinal neoplasm. CLINICAL PRESENTATION A 52-yr-old female who presented with neck pains with duration of 1 yr was admitted to our hospital. Physical examination revealed moderate rigidity in the neck and grade 5 muscle strength in both upper and lower limbs. Preoperative magnetic resonance imaging (MRI) scans demonstrated a left-sided lesion at the C3-C4 intervertebral foraminal area. Under C-arm fluoroscopy navigation and neuromonitoring, the endoscope was properly positioned on the same side of the tumor, and a small part of the left C3 inferior and C4 superior lamina were first removed by an endoscopic drill to enlarge the interlaminar space. Next, through an endoscopic working canal, the left intervertebral ligamentum flavum was removed to fully expose the tumor. The tumor mass was finally resected in a piecemeal approach. Postoperative MRI confirmed complete tumor resection. CONCLUSION This is the first case report of a total removal of a cervical foraminal schwannoma with a percutaneous spinal endoscopic procedure.

A second administration of glucarpidase in a different cycle of high-dose methotrexate: Is it safe and effective in adults?

2020 ◽  
pp. 107815522094646 ◽  
Author(s):  
Amalia Domingo-González ◽  
Santiago Osorio ◽  
Elena Landete ◽  
Silvia Monsalvo ◽  
Jose L. Díez-Martín
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Adverse Events ◽  
Kidney Injury ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate ◽  
First Case ◽  
Methotrexate Concentration ◽  
Unknown Area

Introduction Methotrexate intoxication following high-dose methotrexate-induced acute kidney injury is a life-threatening complication. Glucarpidase can quickly reduce extracellular methotrexate to safe levels, but the effectiveness and safety of its use in different episodes of nephrotoxicity remain an unknown area. Case Report A 30-year-old male diagnosed with acute lymphoblastic T-cell lymphoma received methotrexate 5 g/m2 intravenous (IV) as part of the first consolidation cycle. On Consolidation 3, he restarted methotrexate at a dose of 3 g/m2 IV showing slow methotrexate elimination, associated myelosuppression, and hepatic toxicity. Glucarpidase was administered (total dose of 2000 International Units (IU)). No adverse events were observed, and his renal function returned to normal. One hundred and six days later, he was diagnosed with leptomeningeal and cerebellar relapse and treatment with methotrexate 3,5 g/m2 IV day 1 and cytosine arabinoside (Ara-C) 2 g/m2 IV twice per day days 1, 3, and 5 was started. At 36 h from methotrexate infusion, serum creatinine increased up to 1.89 mg/dL and methotrexate concentration was 100 µmol/L. Management and Outcome: Ara-C was suspended, and a second administration of glucarpidase (2000 IU) was dispensed. No adverse events were noticed, methotrexate levels decreased and renal function progressively improved, recovering completely three weeks later. Discussion The effectiveness and safety of the use of glucarpidase in different episodes of nephrotoxicity remain an unknown area, and the rate and consequences of antiglucarpidase antibody formation remain poorly understood. This case report is, to our knowledge, the first case of a second administration of glucarpidase in a different cycle of high-dose methotrexate in an adult patient.

scholarly journals Case Report of a Rare Incidence of IgH Amplification Leading to Acute Kidney Injury in a Multiple Myeloma Patient

2021 ◽  
pp. 274-278
Author(s):  
Sowmya Thanikachalam ◽  
Vijay Kumar Srinivasalu ◽  
K.S. Nataraj ◽  
Sharat Damodar ◽  
Manjula Das
Keyword(s):  
Multiple Myeloma ◽  
Acute Kidney Injury ◽  
Case Report ◽  
Heavy Chain ◽  
Kidney Injury ◽  
Bone Marrow Aspiration ◽  
Structural Abnormality ◽  
Cell Transplant ◽  
Multiple Myeloma Patient ◽  
First Case

We present a case report of a 62-year-old male, treated for kappa light chain multiple myeloma with chemotherapy followed by autologous stem cell transplant (ASCT) in 2014. He has been in complete remission for 4 years. In 2018, he was evaluated for hypercreatinemia and acute kidney injury(AKI) with a suspicion of disease relapse; he underwent evaluation with bone marrow aspiration cytology which showed no evidence of relapse. However, careful cytogenetic analyses showed IgH amplification (14q32) which probably was the cause for AKI in the absence of any structural abnormality in the kidney. Heavy chain deposition leads to AKI in multiple myeloma, and its association with IgH amplification leading to AKI is reported here. Though heavy chain deposition leading to AKI is common, IgH amplification at chromosome level is the first case observed.

Coagulopthy, acute kidney injury and death following Hypnale zara envenoming – The first case report from Sri Lanka

Toxicon ◽  
2011 ◽  
Vol 58 (8) ◽  
pp. 641-643 ◽  
Author(s):  
Kalana Maduwage ◽  
Keerthi Kularatne ◽  
Abdul Wazil ◽  
Indika Gawarammana
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Sri Lanka ◽  
Kidney Injury ◽  
First Case

scholarly journals Ibrutinib-associated sever skin toxicity: A case of multiple inflamed skin lesions and cellulitis in a 68-year-old male patient with relapsed chronic lymphocytic leukemia – Case report and literature review

2019 ◽  
Vol 26 (2) ◽  
pp. 487-491 ◽  
Author(s):  
R Ghasoub ◽  
A Albattah ◽  
S Elazzazy ◽  
R Alokka ◽  
A Nemir ◽  
...  
Keyword(s):  
Case Report ◽  
Growth Factor ◽  
Chronic Lymphocytic Leukemia ◽  
Male Patient ◽  
Skin Toxicity ◽  
Lymphocytic Leukemia ◽  
Lower Limbs ◽  
Pigmented Lesions ◽  
First Case ◽  
Factor C

Introduction Ibrutinib is an oral inhibitor of Bruton’s tyrosine kinase that is used for a variety of B cell hematological malignancies. Skin and subcutaneous tissue manifestations have been reported and were witnessed in up to 32% of the patients on ibrutinib. The mechanism in which ibrutinib can cause skin toxicities has been thought due to the inhibition of epidermal growth factor; c-Kit and platelet-derived growth factor receptor). Here, we report a case of an elderly chronic lymphocytic leukemia patient who developed multiple inflamed lesions and lower limb cellulitis in 100 days after initiating ibrutinib therapy. Case report A 68-year-old male patient with relapsed chronic lymphocytic leukemia was started on ibrutinib 420 mg orally daily following multiple lines of therapy. Three months following ibrutinib, the patient developed multiple hyper pigmented lesions over both forearms then over both thighs; buttocks and lower limbs. The lesions were labeled as ecthyma and cellulitis that started as papules, which progressed to pustules. Management and outcomes The patient required admission in which he received prolonged course of antibiotics. Biopsy from the wound showed soft tissue fragment infiltrated by acute and chronic inflammatory cells with necrosis; rare foreign body giant cells and granulation tissue formation; suggestive of abscess. Subsequently, ibrutinib was stopped permanently. Discussion This is the first case description of an ibrutinib-associated sever skin toxicity in Qatar. The provided information regarding the clinical descriptions of toxicity profiles in general and skin-based in particular is valuable information for daily clinical practice, especially when selecting the optimum first-line treatment for the patient.

Ribociclib induced acute kidney injury: A case report

2021 ◽  
pp. 107815522110072
Author(s):  
Ilkay Gulturk ◽  
Mesut Yilmaz ◽  
Aykut Ozmen ◽  
Seher Yıldız Tacar ◽  
Gülçin Sahingoz Erdal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Acute Kidney Injury ◽  
Case Report ◽  
Dose Reduction ◽  
Metastatic Breast ◽  
Kidney Injury ◽  
Treatment Discontinuation ◽  
Close Monitoring ◽  
First Case ◽  
Grade 3

Introduction Among females, breast cancer is the most common type of cancer. Hormon receptor positive (HR+) subtype constitutes 75% of the diagnosed breast cancers. Combination of the cyclin D-cyclin-dependent kinase 4/6 (CDK4/6) inhibitor and endocrine therapy significantly improves overall survival and progression-free survival. Ribociclib is an oral CDK 4/6 inhibitor and some adverse effects are identified. According to MONALEESA 2-3-7 studies, no adverse effect (AE) were reported due to grade 3 or 4 acute kidney injury (AKI) that caused treatment discontinuation. Case report We report a ribociclib-induced grade 3 AKI in an elderly woman who was treated for metastatic breast cancer. During first cycle of therapy, she was admitted to the oncology clinic with diagnosis of AKI. Management and outcome: Ribociclib treatment was discontinued and secondary causes of AKI were excluded. During the follow-up, kidney function values returned to the normal range spontaneously. Ribociclib treatment was re-initiated by reducing the dose (400 mg daily). Despite dose reduction; grade 3 AKI recurred when ribociclib was re-initiated and the drug was permanently discontinued. Discussion According to MONALEESA 2-3-7 studies; no AE were reported due to grade 3 or 4 AKI. Despite these studies, the FDA reported that 20% of patients with ribociclib + letrozole combination therapy may have any stage elevation of creatinine. Ribociclib induced creatinine elevations are generally mild (grade 1–2) and can be managed by dose reduction or close monitoring of creatinine levels. We report the first case of grade 3 AKI that caused treatment discontinuation following administration of ribociclib.

scholarly journals Rhabdomyolysis After the Use of Percussion Massage Gun: A Case Report

2020 ◽  
Author(s):  
Jian Chen ◽  
Fan Zhang ◽  
Haizhu Chen ◽  
Hui Pan
Keyword(s):  
Creatine Kinase ◽  
Case Report ◽  
Underlying Disease ◽  
Deficiency Anemia ◽  
Electrolyte Balance ◽  
The Public ◽  
Life Threatening Illness ◽  
First Case ◽  
Urine Alkalinization ◽  
Life Threatening

Abstract Objective Percussion massage guns are commonly used by professional athletes and nonathletes worldwide for warmup and physical recovery; however, there are no published clinical or evidence-based reports on percussion guns regarding their benefits, indications, contraindications, and even side effects. The purpose of this case report is to describe the first case of rhabdomyolysis as a severe and potentially life-threatening illness following use of a percussion gun. Methods (Case Description) A young Chinese woman with untreated iron deficiency anemia presented with fatigue and pain in her thigh muscles for 3 days and tea-colored urine for 1 day, after cycling and subsequently receiving percussion gun treatment by her coach for the purpose of massage and relaxing tired muscles. Muscle tenderness and multiple hematomas were found on her thighs, and her urinalysis indicated hemoglobinuria. Her serum creatine kinase was reported as “undetectably high,” a hallmark of serious muscle damage leading to a diagnosis of severe rhabdomyolysis. Aggressive intravenous fluid resuscitation, urine alkalinization via intravenous alkaline solution, assessment of urine output, and maintenance of electrolyte balance were administered during hospitalization. Results The patient’s clinical presentation gradually improved with the decline of creatine kinase, and she recovered well during follow-up. Conclusion A case of severe rhabdomyolysis after percussion massage should alert caregivers, sports professionals, and the public to suspect and recognize the potentially serious adverse effects of percussion guns and to ensure that percussion massage guns be used appropriately and safely in rehabilitation therapy, especially in individuals with an underlying disease or condition. Research is needed to examine the benefits, indications, contraindications, and adverse reactions of percussion guns.

scholarly journals Acute kidney injury with partial Fanconi syndrome in a patient with leptospirosis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Marc Weiner ◽  
Matteo Coen ◽  
Jacques Serratrice ◽  
Thomas A. Mavrakanas ◽  
Antonio Leidi
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Injury ◽  
Liver Function Tests ◽  
Immunoglobulin M ◽  
Lower Limbs ◽  
Tubular Dysfunction ◽  
Kidney Dysfunction ◽  
Diagnostic Challenge ◽  
Amoxicillin Clavulanate

Abstract Background Leptospirosis is an underdiagnosed bacterial infection with nonspecific symptoms, hence, a diagnostic challenge. Identifying a case of leptospirosis in Switzerland is uncommon. Although kidney complications are frequent in severe forms, including tubular dysfunction, observing this complication is rare in our country. We report the case of a patient with leptospirosis and kidney dysfunction, which was notable for proximal tubulopathy. This case report describes the diagnosis and management of this patient’s tubular dysfunction. Case presentation A 34-year-old Caucasian male known for alcohol and drug abuse presented to our emergency department suffering from severe pain in the lower limbs, jaundice, and fever with flu-like symptoms. Physical examination was not contributory. Blood tests showed cytopenia, elevated inflammatory markers, acute kidney injury, and altered liver function tests with predominant cholestasis. Urinalysis showed proteinuria and significant glycosuria without concomitant hyperglycemia. Leptospirosis was suspected and confirmed by both positive serum polymerase chain reaction and elevated immunoglobulin M for Leptospira interrogans. The patient was treated with intravenous amoxicillin–clavulanate and doxycycline for 7 days. After antibiotic treatment, symptoms disappeared, and kidney dysfunction completely resolved. Conclusion Our case focuses on the description of leptospirosis-related acute kidney injury with proximal tubular dysfunction, which is a rare finding in Switzerland.

St. John’s Wort (Hypericum perforatum)-Related Acute Kidney Injury

2021 ◽  
pp. 1-3
Author(s):  
Zelal Adibelli ◽  
Ilayda Karacay ◽  
Murat Demir ◽  
Cevdet Duran
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Sleep Disorder ◽  
Kidney Failure ◽  
Hypericum Perforatum ◽  
Kidney Injury ◽  
Acute Kidney Failure ◽  
Normal Kidney ◽  
Herbal Products ◽  
First Case

Some herbal products were reported to cause nephrotoxicity through different mechanisms. This case report defines an acute kidney injury (AKI) in a patient who used <i>Hypericum perforatum</i> tea as a sleep disorder remedy. The patient developed AKI after ingestion of tea prepared from <i>Hypericum perforatum</i> and underwent hemodialysis because of acute kidney failure. After 1 week, the kidney recovered, and she was discharged with normal kidney function. This is the first case reported having acute kidney failure caused by ingestion of <i>Hypericum perforatum</i>.

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