Acute hepatitis secondary to abuse of cocaine, associated with severe rhabdomyolysis Hepatite aguda secundaria ao abuso de cocaina, associada a severa rabdomiolise

Cocaine is a drug with a noticeable ability to adversely affect almost every organ in the body, and can cause a multitude of secondary multisystem abnormalities. In the present study, we report three cases of acute liver failure complicated by rhabdomyolysis and acute kidney injury following cocaine and alcohol use. Disease onset, clinical manifestations, laboratory data, diagnosis, and treatment of each patient were recorded. The presence of multifactorial causes for the occurrence of liver failure and rhabdomyolysis was noted in the three reported cases. Laboratory tests revealed that serum trasaminases and creatine phosphokinase (CPK) levels increased, and symptoms of acute renal failure were present, which provided an accurate diagnosis of acute liver failure complicated by severe rhabdomyolysis and acute kidney injury requiring dyalisis. Rhabdomyolysis is a condition of hypermyoglobinuria, being one of the main factors that promote deterioration of renal function. Early phase therapy involved support for fluid resuscitation associated with dialysis therapy with strict control of renal function. All three patients developed multiple organ involvement, but only one died due to the severity of the condition. Considering the three cases presented, we conclude that liver failure, complicated by rhabdomyolysis, secondary to cocaine and alcohol use, may have a poor clinical prognosis, depending on several factors. Physicians should be aware of the potential effects caused by cocaine to manage the multiple complications associated with cocaine abuse. Keywords: Cocaine; Acute kidney injury; Rhabdomyolysis; Liver failure, acute. A cocaina e uma droga com notoria capacidade de afetar adversamente quase todos os orgaos do corpo e pode causar uma infinidade de anormalidades multisistemicas secundarias. No presente estudo, relatamos tres casos de insuficiencia hepatica aguda complicada por rabdomiolise e lesao renal aguda apos consumo de cocaina e alcool. O inicio da doenca, as manifestacoes clinicas, os dados laboratoriais, o diagnostico e a terapeutica de cada paciente foram registrados. Nota-se a presenca de causas multifatoriais para a ocorrencia de insuficiencia hepatica e rabdomiolise nos tres casos relatados. Os testes laboratoriais revelaram que a concentracao serica de transaminases, bem como os de creatinafosfoquinase (CPK) aumentaram e que os sintomas de insuficiencia renal aguda estavam presentes, o que forneceu um diagnostico exato de insuficiencia hep