Hepatocellular carcinoma,polymyositis,rhabdomyolysis,and acute renal failure.
A 55 yr-old man presented with progressive muscle weakness and oliguria for 5 days. Laboratory findings suggested rhabdomyolysis complicated with acute renal failure. A diagnosis of polymyositis was based upon the proximal muscle weakness on both upper and lower limbs, elevated muscle enzyme levels, muscle biopsy findings and the needle electromyography findings. The muscle biopsy showed extensive muscle necrosis and calcification. Investigations for underlying malignancy demonstrated hepatocellular carcinoma. The patient was managed with hemodialysis and high dose prednisolone. His renal function was fully recovered and his muscle power did improve slightly, but he died of a rupture of the hepatic tumor. In our view, this is an interesting case in that the hepatocellular carcinoma was associated with polymyositis and fulminant rhabdomyolysis-induced acute renal failure requiring hemodialysis.
Kim
Mi-Jeong
MJ
Division of Rheumatology, Department of Internal Medicine, Holy Family Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Kim
Jin-A
JA
Sung
Mi-Sook
MS
Min
Jun-Ki
JK
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D017285:Polymyositis / Q000150:complications / Q000175:diagnosis*; D012206:Rhabdomyolysis / Q000175:diagnosis* / Q000209:etiology