Xenobiotic-Induced Rhabdomyolysis and its Relationship with Paraclinical Variables in Poisoned Patients

Maryam Zaare Nahandi; Amir Mohammad  Kazemifar; Safoura Rafiee; Ali Banagozar Mohammadi

doi:10.18502/jimc.v6i1.11852

Maryam Zaare Nahandi Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Amir Mohammad Kazemifar Department of Internal Medicine, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
Safoura Rafiee School of Medicine, Islamic Azad University, Tabriz Branch, Tabriz, Iran
Ali Banagozar Mohammadi Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

DOI: https://doi.org/10.18502/jimc.v6i1.11852

Keywords: Creatine kinase, Creatinine, Kidney, Liver, Rhabdomyo-lysis, Urea

Abstract

Background: Rhabdomyolysis is a clinical syndrome that occurs due to the damage to striated muscles after various conditions, one of the most common of which is drug poisoning. This study examined rhabdomyolysis in all types of poisoned hospitalized patients and its relationship with paraclinical variables, such as Creatine Phosphokinase (CPK) and the patients’ level of creatinine, blood urea, and liver enzymes (alanine aminotransferase and aspartate aminotransferase).

Methods: A total of 105 patients suffering from rhabdomyolysis caused by poisoning were enrolled. The necessary information of the patients was extracted from their records, recorded in the research questionnaire, and analyzed using SPSS. Descriptive statistics indicators and Pearson’s linear correlation coefficient were used for statistical analysis.

Results: The prevalence of rhabdomyolysis was 7.2%. Ninety-seven (92.4%) and 8 (7.6%) poisoned patients suffering from rhabdomyolysis were male and female, respectively. The most prevalent poisoning resulting in rhabdomyolysis was methadone poisoning (31.42%). There was a significantly positive correlation between CPK and urea, Cr, and AST; i.e., by increasing CPK level, urea, Cr, and AST levels also increased, and by decreasing CPK level, urea, Cr, and AST levels also decreased. The incidence of an abnormal aminotransferase in the setting of rhabdomyolysis was high. In addition, the frequency of Acute Kidney Injury (AKI) ranged from 10.9 to over 16.9%.

Conclusion: Xenobiotics (e.g., opioids, drugs, alcohol, and poisons), xenobiotic-induced coma, and/or xenobiotic-induced seizure are the causes of rhabdomyolysis in the present study. Briefly, the research findings revealed the highest prevalence of rhabdomyolysis in male youth poisoned by narcotics.