Occult elevation of CK as a manifestation of rhabdomyolysis in the elderly.
OBJECTIVE
To evaluate the incidence, etiology and clinical course of rhabdomyolysis in hospitalized elderly patients.


METHODS
Retrospective case series.


METHODS
Acute geriatric department of a university-affiliated teaching hospital.


METHODS
Twenty-three patients who fulfilled our criteria of rhabdomyolysis. Criteria for inclusion were the finding of elevated serum creatine kinase of five-fold or greater above the upper reference limit and greater than 97% MM isoenzyme.


RESULTS
In a 3-year period 23 patients out of 2,870 admissions fulfilled the criteria for rhabdomyolysis, an incidence rate of 0.8%. Diseases or insults associated with rhabdomyolysis were, in order of frequency, acute immobilization, infectious disease, cerebrovascular accident, hyperosmolar state, hyponatremia, hypernatremia, hypothermia, and a fall. Twenty-two patients recovered from the acute illness; one patient died from respiratory failure. Seventeen patients had renal failure (serum creatinine greater than 180 mumol/L), none necessitating dialysis. Serum creatinine always declined following recovery.


CONCLUSIONS
Elevation of CK with few other clinical features of rhabdomyolysis is common in admissions to a geriatric service. It is due to complete immobilization resulting from acute illness. Renal failure is mild and reversible, and the prognosis for recovery is excellent.
Marcus
E L
EL
Geriatrics Department, Shaare Zedek Medical Center, Jerusalem, Israel.
Rudensky
B
B
Sonnenblick
M
M
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003402:Creatine Kinase / Q000097:blood*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D008297:Male; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000175:diagnosis* / Q000209:etiology
D003402:Creatine Kinase