Acute Rhabdomyolysis Associated with Cocaine Intoxication
Because an increasing number of patients were arriving at our emergency room with cocaine intoxication and rhabdomyolysis, we reviewed our experience with such patients. We identified 39 patients seen at our institution over an eight-year period with acute rhabdomyolysis after cocaine use. The patie...
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| Veröffentlicht in: | The New England journal of medicine 1988-09, Vol.319 (11), p.673-677 |
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| creator | Roth, David Alarcón, Francisco J Fernandez, John A Preston, Richard A Bourgoignie, Jacques J |
| description | Because an increasing number of patients were arriving at our emergency room with cocaine intoxication and rhabdomyolysis, we reviewed our experience with such patients.
We identified 39 patients seen at our institution over an eight-year period with acute rhabdomyolysis after cocaine use. The patients' mean creatine kinase level was 12,187 U per liter (range, 1756 to 85,000). Thirteen of the 39 patients (33 percent) had acute renal failure; 6 of them died. In comparison to the patients with normal renal function, those with renal failure were more often admitted with profound hypotension (46 vs. 4 percent; P |
| doi_str_mv | 10.1056/NEJM198809153191103 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_15029384</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>15029384</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-fdedc444ebae2fb3d5c2d9f2ac2458c9ff82ca6458b5733d6224bc5712ae3ed83</originalsourceid><addsrcrecordid>eNp9kNFLwzAQxoMoc07_AhEKii9SzSVpmzyOMXUyFUSfS5qkLKNtZtOi--_N2NiDiPdyH9zvvjs-hM4B3wJO0ruX6dMzCM6xgISCAMD0AA2DpjFjOD1EQ4wJj1km6DE68X6JQwETAzSgDAjlyRCJseo7E70tZKFdvXbV2lsfjb13ysrO6OjLdoto4pS0jYlmTee-rZKddc0pOipl5c3Zro_Qx_30ffIYz18fZpPxPFYsJV1caqMVY8wU0pCyoDpRRIuSSEVYwpUoS06UTIMukoxSnRLCCpVkQKShRnM6Qtdb31XrPnvju7y2Xpmqko1xvc8hwURQzgJ4-Qtcur5twm85cA4hBQEbim4p1TrvW1Pmq9bWsl3ngPNNrPkfsYati513X9RG73d2OYb51W4uvZJV2cpGWb_HMpJRgDRgN1usrn3emGX979Ef9kKK8Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1881793914</pqid></control><display><type>article</type><title>Acute Rhabdomyolysis Associated with Cocaine Intoxication</title><source>MEDLINE</source><source>ProQuest Central UK/Ireland</source><creator>Roth, David ; Alarcón, Francisco J ; Fernandez, John A ; Preston, Richard A ; Bourgoignie, Jacques J</creator><creatorcontrib>Roth, David ; Alarcón, Francisco J ; Fernandez, John A ; Preston, Richard A ; Bourgoignie, Jacques J</creatorcontrib><description>Because an increasing number of patients were arriving at our emergency room with cocaine intoxication and rhabdomyolysis, we reviewed our experience with such patients.
We identified 39 patients seen at our institution over an eight-year period with acute rhabdomyolysis after cocaine use. The patients' mean creatine kinase level was 12,187 U per liter (range, 1756 to 85,000). Thirteen of the 39 patients (33 percent) had acute renal failure; 6 of them died. In comparison to the patients with normal renal function, those with renal failure were more often admitted with profound hypotension (46 vs. 4 percent; P<0.001), hyperpyrexia (69 vs. 15 percent; P<0.001), and markedly elevated serum creatine kinase levels (mean, 28,084 vs. 7931 U per liter; P<0.01). Disseminated intravascular coagulation developed in seven patients with renal failure. All six deaths were in this group. Severe hepatic dysfunction was found in 11 patients with renal failure.
We conclude that cocaine intoxication can cause acute rhabdomyolysis with acute renal failure, severe liver dysfunction, and disseminated intravascular coagulation and that the mortality rate among patients with this syndrome is high. (N Engl J Med 1988; 319:673–7.)
THIRTY million Americans are estimated to have tried cocaine at least once, and 5 million may use it regularly.
1
,
2
What was previously "social and recreational" intranasal use has escalated to frequent and habitual smoking of the alkaloid form of cocaine ("free base"). A growing literature describes the potentially life-threatening consequences of cocaine use, which result principally from its effects on the cardiovascular and central nervous systems.
3
4
5
6
In this article we describe a series of patients with cocaine intoxication, rhabdomyolysis, and acute renal failure.
Methods
To identify patients with cocaine intoxication and rhabdomyolysis, we reviewed the computerized registry of hospital discharges . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM198809153191103</identifier><identifier>PMID: 3412385</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Boston, MA: Massachusetts Medical Society</publisher><subject>Acute Disease ; Acute Kidney Injury - chemically induced ; Adult ; Amphetamines ; Biological and medical sciences ; Blood pressure ; Chemical and Drug Induced Liver Injury ; Cocaine ; Cocaine - poisoning ; Creatine Kinase - blood ; Disseminated Intravascular Coagulation - etiology ; Drug addictions ; Emergency medical care ; Female ; Gangrene ; Hospitals ; Humans ; Immunoassay ; Kidney diseases ; Laboratories ; Male ; Medical sciences ; Nephrology ; Patients ; Rhabdomyolysis ; Rhabdomyolysis - chemically induced ; Toxicology ; Uric acid ; Urine</subject><ispartof>The New England journal of medicine, 1988-09, Vol.319 (11), p.673-677</ispartof><rights>1989 INIST-CNRS</rights><rights>Copyright Massachusetts Medical Society Sep 15, 1988</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-fdedc444ebae2fb3d5c2d9f2ac2458c9ff82ca6458b5733d6224bc5712ae3ed83</citedby><cites>FETCH-LOGICAL-c462t-fdedc444ebae2fb3d5c2d9f2ac2458c9ff82ca6458b5733d6224bc5712ae3ed83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1881793914?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=7273116$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3412385$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roth, David</creatorcontrib><creatorcontrib>Alarcón, Francisco J</creatorcontrib><creatorcontrib>Fernandez, John A</creatorcontrib><creatorcontrib>Preston, Richard A</creatorcontrib><creatorcontrib>Bourgoignie, Jacques J</creatorcontrib><title>Acute Rhabdomyolysis Associated with Cocaine Intoxication</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>Because an increasing number of patients were arriving at our emergency room with cocaine intoxication and rhabdomyolysis, we reviewed our experience with such patients.
We identified 39 patients seen at our institution over an eight-year period with acute rhabdomyolysis after cocaine use. The patients' mean creatine kinase level was 12,187 U per liter (range, 1756 to 85,000). Thirteen of the 39 patients (33 percent) had acute renal failure; 6 of them died. In comparison to the patients with normal renal function, those with renal failure were more often admitted with profound hypotension (46 vs. 4 percent; P<0.001), hyperpyrexia (69 vs. 15 percent; P<0.001), and markedly elevated serum creatine kinase levels (mean, 28,084 vs. 7931 U per liter; P<0.01). Disseminated intravascular coagulation developed in seven patients with renal failure. All six deaths were in this group. Severe hepatic dysfunction was found in 11 patients with renal failure.
We conclude that cocaine intoxication can cause acute rhabdomyolysis with acute renal failure, severe liver dysfunction, and disseminated intravascular coagulation and that the mortality rate among patients with this syndrome is high. (N Engl J Med 1988; 319:673–7.)
THIRTY million Americans are estimated to have tried cocaine at least once, and 5 million may use it regularly.
1
,
2
What was previously "social and recreational" intranasal use has escalated to frequent and habitual smoking of the alkaloid form of cocaine ("free base"). A growing literature describes the potentially life-threatening consequences of cocaine use, which result principally from its effects on the cardiovascular and central nervous systems.
3
4
5
6
In this article we describe a series of patients with cocaine intoxication, rhabdomyolysis, and acute renal failure.
Methods
To identify patients with cocaine intoxication and rhabdomyolysis, we reviewed the computerized registry of hospital discharges . . .</description><subject>Acute Disease</subject><subject>Acute Kidney Injury - chemically induced</subject><subject>Adult</subject><subject>Amphetamines</subject><subject>Biological and medical sciences</subject><subject>Blood pressure</subject><subject>Chemical and Drug Induced Liver Injury</subject><subject>Cocaine</subject><subject>Cocaine - poisoning</subject><subject>Creatine Kinase - blood</subject><subject>Disseminated Intravascular Coagulation - etiology</subject><subject>Drug addictions</subject><subject>Emergency medical care</subject><subject>Female</subject><subject>Gangrene</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunoassay</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nephrology</subject><subject>Patients</subject><subject>Rhabdomyolysis</subject><subject>Rhabdomyolysis - chemically induced</subject><subject>Toxicology</subject><subject>Uric acid</subject><subject>Urine</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1988</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kNFLwzAQxoMoc07_AhEKii9SzSVpmzyOMXUyFUSfS5qkLKNtZtOi--_N2NiDiPdyH9zvvjs-hM4B3wJO0ruX6dMzCM6xgISCAMD0AA2DpjFjOD1EQ4wJj1km6DE68X6JQwETAzSgDAjlyRCJseo7E70tZKFdvXbV2lsfjb13ysrO6OjLdoto4pS0jYlmTee-rZKddc0pOipl5c3Zro_Qx_30ffIYz18fZpPxPFYsJV1caqMVY8wU0pCyoDpRRIuSSEVYwpUoS06UTIMukoxSnRLCCpVkQKShRnM6Qtdb31XrPnvju7y2Xpmqko1xvc8hwURQzgJ4-Qtcur5twm85cA4hBQEbim4p1TrvW1Pmq9bWsl3ngPNNrPkfsYati513X9RG73d2OYb51W4uvZJV2cpGWb_HMpJRgDRgN1usrn3emGX979Ef9kKK8Q</recordid><startdate>19880915</startdate><enddate>19880915</enddate><creator>Roth, David</creator><creator>Alarcón, Francisco J</creator><creator>Fernandez, John A</creator><creator>Preston, Richard A</creator><creator>Bourgoignie, Jacques J</creator><general>Massachusetts Medical Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7U7</scope><scope>C1K</scope></search><sort><creationdate>19880915</creationdate><title>Acute Rhabdomyolysis Associated with Cocaine Intoxication</title><author>Roth, David ; Alarcón, Francisco J ; Fernandez, John A ; Preston, Richard A ; Bourgoignie, Jacques J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-fdedc444ebae2fb3d5c2d9f2ac2458c9ff82ca6458b5733d6224bc5712ae3ed83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1988</creationdate><topic>Acute Disease</topic><topic>Acute Kidney Injury - chemically induced</topic><topic>Adult</topic><topic>Amphetamines</topic><topic>Biological and medical sciences</topic><topic>Blood pressure</topic><topic>Chemical and Drug Induced Liver Injury</topic><topic>Cocaine</topic><topic>Cocaine - poisoning</topic><topic>Creatine Kinase - blood</topic><topic>Disseminated Intravascular Coagulation - etiology</topic><topic>Drug addictions</topic><topic>Emergency medical care</topic><topic>Female</topic><topic>Gangrene</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Immunoassay</topic><topic>Kidney diseases</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nephrology</topic><topic>Patients</topic><topic>Rhabdomyolysis</topic><topic>Rhabdomyolysis - chemically induced</topic><topic>Toxicology</topic><topic>Uric acid</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roth, David</creatorcontrib><creatorcontrib>Alarcón, Francisco J</creatorcontrib><creatorcontrib>Fernandez, John A</creatorcontrib><creatorcontrib>Preston, Richard A</creatorcontrib><creatorcontrib>Bourgoignie, Jacques J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roth, David</au><au>Alarcón, Francisco J</au><au>Fernandez, John A</au><au>Preston, Richard A</au><au>Bourgoignie, Jacques J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute Rhabdomyolysis Associated with Cocaine Intoxication</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>1988-09-15</date><risdate>1988</risdate><volume>319</volume><issue>11</issue><spage>673</spage><epage>677</epage><pages>673-677</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><coden>NEJMAG</coden><abstract>Because an increasing number of patients were arriving at our emergency room with cocaine intoxication and rhabdomyolysis, we reviewed our experience with such patients.
We identified 39 patients seen at our institution over an eight-year period with acute rhabdomyolysis after cocaine use. The patients' mean creatine kinase level was 12,187 U per liter (range, 1756 to 85,000). Thirteen of the 39 patients (33 percent) had acute renal failure; 6 of them died. In comparison to the patients with normal renal function, those with renal failure were more often admitted with profound hypotension (46 vs. 4 percent; P<0.001), hyperpyrexia (69 vs. 15 percent; P<0.001), and markedly elevated serum creatine kinase levels (mean, 28,084 vs. 7931 U per liter; P<0.01). Disseminated intravascular coagulation developed in seven patients with renal failure. All six deaths were in this group. Severe hepatic dysfunction was found in 11 patients with renal failure.
We conclude that cocaine intoxication can cause acute rhabdomyolysis with acute renal failure, severe liver dysfunction, and disseminated intravascular coagulation and that the mortality rate among patients with this syndrome is high. (N Engl J Med 1988; 319:673–7.)
THIRTY million Americans are estimated to have tried cocaine at least once, and 5 million may use it regularly.
1
,
2
What was previously "social and recreational" intranasal use has escalated to frequent and habitual smoking of the alkaloid form of cocaine ("free base"). A growing literature describes the potentially life-threatening consequences of cocaine use, which result principally from its effects on the cardiovascular and central nervous systems.
3
4
5
6
In this article we describe a series of patients with cocaine intoxication, rhabdomyolysis, and acute renal failure.
Methods
To identify patients with cocaine intoxication and rhabdomyolysis, we reviewed the computerized registry of hospital discharges . . .</abstract><cop>Boston, MA</cop><pub>Massachusetts Medical Society</pub><pmid>3412385</pmid><doi>10.1056/NEJM198809153191103</doi><tpages>5</tpages></addata></record> |
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| subjects | Acute Disease Acute Kidney Injury - chemically induced Adult Amphetamines Biological and medical sciences Blood pressure Chemical and Drug Induced Liver Injury Cocaine Cocaine - poisoning Creatine Kinase - blood Disseminated Intravascular Coagulation - etiology Drug addictions Emergency medical care Female Gangrene Hospitals Humans Immunoassay Kidney diseases Laboratories Male Medical sciences Nephrology Patients Rhabdomyolysis Rhabdomyolysis - chemically induced Toxicology Uric acid Urine |
| title | Acute Rhabdomyolysis Associated with Cocaine Intoxication |
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