title: [Severe rhabdomyolysis secondary to severe hypernatraemic dehydration].
abstract: BACKGROUND
  Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea.
  
  
  METHODS
  Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae.
  
  
  CONCLUSIONS
  Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment.
authors: Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España. Electronic address: Ignacio.mastro@salud.madrid.org.
authors: Ignacio
authors: I
authors: Mastro-Martínez
authors: Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España.
authors: Ana María
authors: AM
authors: Montes-Arjona
authors: Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España.
authors: Margarita
authors: M
authors: Escudero-Lirio
authors: Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España.
authors: Bárbara
authors: B
authors: Hernández-García
authors: Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España.
authors: José
authors: J
authors: Fernández-Cantalejo Padial
mesh_terms: D003402:Creatine Kinase / Q000378:metabolism; D003681:Dehydration / Q000150:complications* / Q000209:etiology / Q000628:therapy; D003967:Diarrhea / Q000150:complications*; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D006955:Hypernatremia / Q000150:complications* / Q000209:etiology; D007223:Infant; D008297:Male; D012206:Rhabdomyolysis / Q000209:etiology* / Q000628:therapy; D012720:Severity of Illness Index; D014839:Vomiting / Q000150:complications
chemical_list: D003402:Creatine Kinase
keywords: Cuidados intensivos pediátricos; Dehydration; Deshidratación; Hipernatremia; Hypernatremia; Pediatric intensive critical care; Rabdomiólisis; Rhabdomyolysis