Rhabdomyolysis in presumed viscero-cutaneous loxoscelism: report of two cases.
Until now, in viscero-cutaneous loxoscelism, discoloured urine has been attributed only to haemoglobinuria induced by the intravascular haemolysis caused by the venom. In this paper, 2 cases (in Brazil) of viscero-cutaneous loxoscelism with rhabdomyolysis and acute renal failure are described. Both patients presented with severe oedema, erythema and dermonecrosis at the bite site. Elevated creatine kinase levels were found in both cases (6841 and 1718 U/L) associated with severe acute renal failure (one required dialysis for 50 days). Therefore, in viscero-cutaneous loxoscelism, rhabdomyolysis secondary to intense local tissue damage can occur and should be considered as a contributing factor in acute renal failure. Creatine kinase should therefore be monitored in viscero-cutaneous loxoscelism to avoid acute renal failure and to reduce the severity of any renal damage.
França
Francisco Oscar de Siqueira
FO
Hospital Vital Brazil, Clínica de Moléstias Infecciosas e Parasitárias, Hospital das Clínicas, São Paulo, Brazil. fosfranca@uol.com.br
Barbaro
Katia Cristina
KC
Abdulkader
Regina Célia Rodrigues de Moraes
RC
D058186:Acute Kidney Injury / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009336:Necrosis; D006435:Renal Dialysis; D012206:Rhabdomyolysis / Q000209:etiology* / Q000473:pathology; D012871:Skin Diseases / Q000209:etiology; D001098:Spider Bites / Q000150:complications* / Q000473:pathology; D013111:Spider Venoms / Q000506:poisoning*
D013111:Spider Venoms