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Open Access Research article

Clinical spectrum of rhabdomyolysis presented to pediatric emergency department

Chun-Yu Chen12, Yan-Ren Lin234, Lu-Lu Zhao5, Wen-Chieh Yang12, Yu-Jun Chang6, Kang-Hsi Wu78 and Han-Ping Wu109*

Author Affiliations

1 Division of Emergency Medicine, Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan

2 School of Medicine, Chung Shan Medical University, Taichung, Taiwan

3 Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan

4 Department of Biological Science and Technology and Institute of Biochemical Engineering, National Chiao Tung University, Hsinchu, Taiwan

5 Department of Pediatrics, Taipei Tzuchi Hospital, the Buddhist Medical Foundation, Taipei, Taiwan

6 Laboratory of Epidemiology and Biostastics, Changhua Christian Hospital, Changhua, Taiwan

7 Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan

8 School of Chinese Medicine, China Medical University, Taichung, Taiwan

9 Department of Pediatrics, Taichung Tzuchi Hospital, the Buddhist Medical Foundation, Taichung, Taiwan

10 Department of Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan

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BMC Pediatrics 2013, 13:134  doi:10.1186/1471-2431-13-134

Published: 3 September 2013

Abstract

Background

Rhabdomyolysis is a potentially life-threatening syndrome that can develop from a variety of causes. The aim of the work is to analyze the clinical spectrum and to evaluate the prevalence of various etiologies in children, who present to the emergency department (ED) with rhabdomyolysis.

Methods

During a 6-year study period, we retrospectively analyzed the medical charts of patients, aged 18 years or younger, with a definite diagnosis of rhabdomyolysis and serum creatinine phosphokinase (CK) levels greater than 1000IU/L. We analyzed the clinical spectrum and evaluated the potential risk factors of acute renal failure (ARF).

Results

Thirty-seven patients (mean age = 10.2 ± 5.5 years), including 26 males and 11 females, were enrolled in the study. Two of the most common presented symptoms in these 37 patients were muscle pain and muscle weakness (83.8% and 73%, respectively). Dark urine was reported in only 5.4% of the patients. The leading cause of rhabdomyolysis in the 0- to 9-year age group was presumed infection, and the leading cause in the 10- to 18-year age group was trauma and exercise. The incidence of ARF associated with rhabdomyolysis was 8.1 % and no child needed for renal replacement therapy (RRT). We did not identify any reliable predictors of ARF or need for RRT.

Conclusions

The classic triad of symptoms of rhabdomyolysis includes myalgia, weakness and dark urine are not always presented in children. The cause of rhabdomyolysis in younger age is different from that of teenager group. However, the prognosis of rhabdomyolysis was good with appropriate management.

Keywords:
Rhabdomyolysis; Emergency department; Children