Fatal rhabdomyolysis in systemic lupus erythematosus.
The authors describe herein the sixth lupus case that evolved with rhabdomyolysis. A 36-year-old woman with systemic lupus erythematosus was admitted to our hospital with malaise, myalgia, dysphagia, fever, preserved muscle strength, leukocytosis (15,600 cells), and increased creatine kinase of 1,358 IU/L that reached 75,000 IU/L in few days. She denied the use of myotoxic drugs and alcohol. Urine 1 showed false positive for hemoglobinuria (myoglobin) without erythrocytes in the sediment, confirming the diagnosis of rhabdomyolysis. Secondary causes were excluded. She was treated with hyperhydration and alkalinization of urine. Despite treatment, the patient developed pulmonary congestion and she died. The authors also review in this article rhabdomyolysis in patients with systemic lupus erythematosus.
Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Cerqueira César, São Paulo, SP, 01246-903, Brazil. jotafc@gmail.com
Jozélio Freire
JF
de Carvalho
Licia Maria Henrique
LM
da Mota
Eloisa
E
Bonfa
D058186:Acute Kidney Injury / Q000175:diagnosis; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000097:blood; D001168:Arthritis / Q000175:diagnosis / Q000188:drug therapy; D001379:Azathioprine / Q000627:therapeutic use; D002738:Chloroquine / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007970:Leukopenia / Q000175:diagnosis / Q000188:drug therapy; D008171:Lung Diseases / Q000188:drug therapy* / Q000628:therapy; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D019226:Oral Ulcer / Q000175:diagnosis / Q000188:drug therapy; D010787:Photosensitivity Disorders / Q000175:diagnosis / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D012121:Respiration, Artificial; D012206:Rhabdomyolysis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D014657:Vasculitis / Q000175:diagnosis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D000974:Antibodies, Antinuclear; D007166:Immunosuppressive Agents; D002738:Chloroquine; D003402:Creatine Kinase; D001379:Azathioprine; D011241:Prednisone