Abstract
OBJECTIVE This study was designed to compare the clinical manifestations, laboratory tests, etiology, and prognosis of children with acute rhabdomyolysis (RM) at various ages. This study was designed to analyze the risk factors for acute kidney injury (AKI) in children with RM and to identify the role of neuromuscular and immunological disorders in children with RM. PATIENTS AND METHODS Clinical data for 55 children with RM were collected and statistically analyzed. Patients were stratified to an infant group (G1) (age <1 yr), preschool group (G2) (age 1-6 yr), school-age group (G3) (age 7-11 yr), and an adolescent group (G4) (age 12-16 yr). RESULTS The most common clinical features were dark urine (53%), myalgia (38%), and fever (24%). Patients in G1 had fever (71%), vomiting (78%), and abnormal urinalysis (14%), without triad clinical manifestations(myalgia, muscle weakness, and dark urine. 55% of patients in G4 group had myalgia; 71% had dark urine; 75% had abnormal urinalysis. The most common cause in each age group was as follows: sepsis (57%) in G1; hereditary neuromuscular diseases (44%) in G2; immunological disorders (40%) in G3; strenuous exercise (50%) in G4. Logistic regression analysis showed that AKI was not correlated with age, gender, or peak creatine phosphokinase. AKI was, however, associated with presence of an electrolyte disorder. CONCLUSION The clinical manifestations and laboratory findings in infants with acute RM are not typical and need to be taken seriously. The presence of an electrolyte disorder is a risk factor for AKI in children with RM. The most common pathogenesis of RM varies among age groups. Congenital hereditary disease and immunological disorders should not be ignored as a cause of RM in children.