title: Severe rhabdomyolysis with renal failure after intranasal cocaine use.
abstract: A case of acute renal failure due to rhabdomyolysis in a patient who used cocaine on a daily basis is presented. In contrast to many prior reports of renal failure occurring with cocaine-associated rhabdomyolysis, our patient did not use intravenous cocaine and did not have any evidence of trauma, seizure, hypotension, hyperthermia, hyperactivity, or coma. His creatine phosphokinase peaked at 448,000 U/liter. He was treated initially with forced diuresis and i.v. furosemide, but he became oliguric, developed pulmonary edema, and required hemodialysis. He recovered fully after 3 weeks of dialysis. The literature is reviewed in an attempt to delineate a rational approach to evaluating cocaine users at risk for rhabdomyolysis.
authors.affiliation: Emergency Medicine and Clinical Toxicology, University of California, Davis Medical Center, Sacramento, USA.
authors.forename: B Z
authors.initials: BZ
authors.lastname: Horowitz
authors.forename: E A
authors.initials: EA
authors.lastname: Panacek
authors.forename: N J
authors.initials: NJ
authors.lastname: Jouriles
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications*; D003402:Creatine Kinase / Q000097:blood; D004630:Emergencies; D006801:Humans; D008297:Male; D006435:Renal Dialysis; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000150:complications
chemical_list: D003402:Creatine Kinase