title: Rhabdomyolysis after infection and taking a cold medicine in a patient who was susceptible to malignant hyperthermia.
abstract: A case of rhabdomyolysis after a possible viral infection and the use of a cold medication is reported. A 41-year-old man who presented with dysarthria, dysphagia, progressive weakness of his muscles and a high grade fever was admitted. He suffered from massive rhabdomyolysis, acute renal failure, and bronchopneumonia. Hemodialysis, antibiotics, and hydration therapy were effective in the treatment of his illness. Although the cause of the rhabdomyolysis was not completely clear, he was subsequently shown to be susceptible to malignant hyperthermia (MH) based on the results of a caffeine-halothane contracture test. When a mild recurrence occurred during a follow-up muscle biopsy, intravenous dantrolene sodium was administered and he improved immediately. This case suggests that MH should be considered in patients with rhabdomyolysis when the cause is unclear. The caffeine-halothane contracture test may also be helpful in the diagnosis.
authors.affiliation: First Department of Internal Medicine, Matsushita Memorial Hospital, Moriguchi, Osaka.
authors.forename: Y
authors.initials: Y
authors.lastname: Kasamatsu
authors.forename: M
authors.initials: M
authors.lastname: Osada
authors.forename: K
authors.initials: K
authors.lastname: Ashida
authors.forename: K
authors.initials: K
authors.lastname: Azukari
authors.forename: K
authors.initials: K
authors.lastname: Yoshioka
authors.forename: A
authors.initials: A
authors.lastname: Ohsawa
mesh_terms: D000328:Adult; D002110:Caffeine; D002744:Chlorpheniramine / Q000009:adverse effects; D003139:Common Cold / Q000188:drug therapy; D003620:Dantrolene / Q000627:therapeutic use; D006221:Halothane; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008305:Malignant Hyperthermia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D009119:Muscle Contraction / Q000187:drug effects; D004366:Nonprescription Drugs / Q000009:adverse effects; D010656:Phenylephrine / Q000009:adverse effects; D010665:Phenylpropanolamine / Q000009:adverse effects; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014777:Virus Diseases / Q000150:complications*
chemical_list: D004366:Nonprescription Drugs; D010656:Phenylephrine; D010665:Phenylpropanolamine; D002110:Caffeine; D002744:Chlorpheniramine; D003620:Dantrolene; D006221:Halothane