title: A rare autopsy case of traumatic rhabdomyolysis associated with intermittent assault.
abstract: Traumatic rhabdomyolysis generally occurs after severe blunt trauma and is acute in onset, associated with severe disease, and potentially lethal. Accordingly, diagnosis of traumatic rhabdomyolysis in patients without massive subcutaneous or intramuscular hemorrhage is difficult, especially in the postmortem period, which is limited in terms of the availability of biochemical examination tools and accurate history of illness. To the best of our knowledge, there are no previous reports of death from traumatic rhabdomyolysis among individuals who did not pursue medical consultation. A previously healthy man in his early sixties had been punched and kicked several times in the previous 2months, but he had not gone to a hospital. He suddenly lost consciousness at his workplace approximately 5days after the most recent assault, and cardiopulmonary arrest occurred when the emergency service arrived. He died the same day, and a medicolegal autopsy was performed. Although several sites of minor subcutaneous and muscle hemorrhage were observed, the cause of death was unclear upon macroscopic assessment. Immunohistochemical staining revealed acute renal failure caused by rhabdomyolysis. We herein report a rare case of fatal traumatic rhabdomyolysis, seemingly associated with minor and apparently nonlethal muscle injury.
authors.affiliation: Department of Forensic Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan. Electronic address: chibafumico@chiba-u.jp.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Chiba
authors.affiliation: Department of Forensic Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Yohsuke
authors.initials: Y
authors.lastname: Makino
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Motomura
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Inokuchi
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Namiko
authors.initials: N
authors.lastname: Ishii
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Torimitsu
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Hoshioka
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Forensic Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Rutsuko
authors.initials: R
authors.lastname: Yamaguchi
authors.affiliation: Department of Forensic Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Sakuma
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Nagasawa
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Hisako
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yajima
authors.affiliation: Department of Forensic Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-8670, Japan.
authors.forename: Hirotaro
authors.initials: H
authors.lastname: Iwase
mesh_terms: D000208:Acute Disease; D003645:Death, Sudden; D006801:Humans; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000209:etiology; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000209:etiology*; D014947:Wounds and Injuries / Q000150:complications*
keywords: Acute kidney injury; Fatal; Rhabdomyolysis; Trauma