CASE REPORTS   

The Journal of Sports Medicine and Physical Fitness 1998 June;38(2):177-9

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: English

Recurrent rhabdomyolysis associated with influenza-like illness in a weight-lifter

Keverline J. P.

Orthopaedic Department, Hamot Medical Center, Erie, PA, USA

Objective. This ­report ­describes a ­unique ­case of recur­ring rhab­dom­yo­ly­sis asso­ciat­ed ­with influen­za-­like ill­ness.
Patient. A 16-­year-old ­black ­male, a phys­i­cal­ly fit ­weight-lift­er, pre­sent­ed com­plain­ing of a ­brief his­to­ry of ­upper res­pir­a­to­ry infec­tion. He had expe­ri­enced mus­cu­lar ­aches and ­observed his ­urine was a ­brown “Coca Cola” col­or. He was diag­nosed ­with an influen­za-­like ill­ness and asso­ciat­ed rhab­dom­yo­ly­sis. He had ­been pre­vi­ous­ly treat­ed for a sim­i­lar epi­sode of flu-­like symp­toms and ­brown ­urine two ­years ­before. The ­patient was treat­ed ­with IV ­fluids and dis­charged on day sev­en. He has ­remained asymp­to­mat­ic. Post-dis­charge mus­cle biop­sy ­results indi­cat­ed a par­tial defi­cien­cy of car­ni­tine pal­mi­toyl­trans­fe­rase II, a ­rare ­defect in mit­o­chon­dri­al metab­olism.
Discussion. Although trau­mat­ic rhab­dom­yo­ly­sis cas­es ­have ­been report­ed, few ­case ­reports ­have ­been doc­u­ment­ed asso­ciat­ing an influen­za-­like ill­ness and rhab­dom­yo­ly­sis. Deficiency of car­ni­tine pal­mi­toyl­trans­fe­rase ­often caus­es non­ex­er­cise-­induced rhab­dom­yo­lysis.
Conclusion. Prevention ­should con­sist and a year­ly influen­za vac­ci­na­tion edu­ca­tion on nutri­tion and exer­cise.