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Resident: OPIOIDS: A Case Of Rhabdomyolysis Due To Alcohol And Opioid Abuse
Poster Title: Resident: OPIOIDS: A Case Of Rhabdomyolysis Due To Alcohol And Opioid Abuse
Submitted on 23 Oct 2019
Author(s): Aileen Polanco, MD, Ibraheem Innab, MD, Paul Mathieu, MD, Samina Fakhr, MD, Victoria Nurpiesov, MD, G.E. Alan Dever, MD, PhD,
Affiliations: WellStar Kennestone Family Medicine Residency
Poster Views: 110
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Poster Information
Abstract: Rhabdomyolysis is defined as an acute increase in serum concentrations of creatine kinase to more than five times the upper normal limit with visible myoglobinuria. [6] Our report is about a severe case of Rhabdomyolysis in a 24 year old Hispanic male with a presenting CK level of 171,234. Multiple etiologies were able to be identified including traumatic and non traumatic causes. Patient’s abuse of opioids and alcohol were the precipitating factors that led to such a severe case of rhabdomyolysis with multiple complications including arrhythmia due to hyperkalemia , compartment syndrome requiring bilateral fasciotomies and AKI that required patient to be on HD for over 1 month.
Summary: Rhabdomyolysis is a life-threatening condition in which skeletal muscle is damaged.[6] Historically Rhabdomyolysis was a disease of military personals in war or crush injuries following Natural disasters such as Earthquakes and tsunamis. Of late, drugs, including opioids and alcohol, have assumed greater importance and in published journals have been implicated in up to 46% of cases.References: [1] Edward W. Boyer, M.D., Ph.D. Management of Opioid Analgesic Overdose. Engl J Med 2012; 367:146-155
[2] Daher, Elizabeth De Francesco, Silva Júnior, Geraldo Bezerra da, Brunetta, Denise Menezes, Pontes, Lícia Borges, & Bezerra, Glaydcianne Pinheiro. (2005). Rhabdomyolysis and acute renal failure after strenuous exercise and alcohol abuse: case report and literature review. Sao Paulo Medical Journal, 123(1), 33-37. 
[3] Raymond Vanholder, Mehmet SÜKRÜ Sever, Ekrem Erek, Noebert Lameire JASN Aug 2000, 11 (8) 1553-1561 
[4] Melli, Giorgia MD, PhD; Chaudhry, Vinay MD; Cornblath, David R. MD. Rhabdomyolysis An Evaluation of 475 Hospitalized Patients. Medicine: Nov.2005 84:6:377-385 
[5] Lane Russell, Phillips Malcolm. Rhabdomyolysis. BMJ 2003; 327 :115
[6] Marc Miller, MD. Causes of Rhabdomyolysis. Uptodate Last updated June 27, 2019
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