title: A case of rhabdomyolysis in the presence of multiple risk factors and dextroamphetamine use.
abstract: A 44-year-old Caucasian woman presented to the emergency room with worsening low back pain and loss of cutaneous sensation over the paraspinal muscles from T10 to S1. The patient had ingested the attention-deficit disorder medication dextroamphetamine before engaging in intense physical exercise with subsequent consumption of 3 alcoholic beverages before developing symptoms. The patient's creatine kinase levels remained elevated for 8 days with constant severe pain under standard treatment for rhabdomyolysis. Despite stabilization of pain and laboratory values at discharge, the patient continues to experience low paraspinal back pain. In patients with risk factors for rhabdomyolysis, the use of dextroamphetamine should be monitored closely. Outside our findings, there is no literature linking dextroamphetamine with rhabdomyolysis at nontoxic concentrations or with use of the supplement caffeine containing weight loss supplement, Hydroxycut. The authors believe that further research into the potential role of dextroamphetamine use in the setting of other risk factors for rhabdomyolysis is warranted.
authors.affiliation: Tulane University School of Medicine, New Orleans, Louisiana, USA. jsantoro@tulane.edu
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Santoro
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Black
authors.forename: L Lee
authors.initials: LL
authors.lastname: Hamm
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use; D003913:Dextroamphetamine / Q000009:adverse effects* / Q000627:therapeutic use; D015444:Exercise; D005260:Female; D006801:Humans; D028321:Plant Preparations / Q000009:adverse effects; D012206:Rhabdomyolysis / Q000175:diagnosis* / Q000209:etiology*; D012307:Risk Factors
chemical_list: D000697:Central Nervous System Stimulants; D028321:Plant Preparations; C512049:hydroxycut; D003913:Dextroamphetamine