Intramuscular heroin-induced severe rhabdomyolysis and acute kidney injury—a case report
Abstract Rhabdomyolysis (RM) is characterised by the breakdown of skeletal muscle tissue, releasing toxic intracellular components into circulation. It presents with dark urine, muscle weakness, myalgia, and elevated creatine phosphokinase levels (CPK). Drug-induced RM is aetiologically significant....
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Veröffentlicht in: | Oxford Medical Case Reports 2024-11, Vol.2024 (11), p.omae134 |
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creator | Dimov, Nikolay Sultana, Tahsin Dafeeah, Aishah Choudhury, Hafsa Nikolov, Dimitar |
description | Abstract
Rhabdomyolysis (RM) is characterised by the breakdown of skeletal muscle tissue, releasing toxic intracellular components into circulation. It presents with dark urine, muscle weakness, myalgia, and elevated creatine phosphokinase levels (CPK). Drug-induced RM is aetiologically significant. This case report describes a 25-year-old male who developed severe RM and Acute Kidney Injury (AKI) after intramuscular (IM) heroin administration as a first time user. IM heroin use can induce higher CPK levels due to direct myocyte toxicity and mechanical trauma. The highly vascularised gluteal muscles with type 1 fibres at the injection site likely exacerbated the severity. Additional factors included lower mitochondrial density in males and alcohol exposure. Despite aggressive fluid resuscitation, renal replacement therapy (RRT) was required, and the patient responded well to haemodialysis. This case highlights AKI as a severe complication of IM heroin use, underscoring the need for further research into drug-induced RM. |
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Rhabdomyolysis (RM) is characterised by the breakdown of skeletal muscle tissue, releasing toxic intracellular components into circulation. It presents with dark urine, muscle weakness, myalgia, and elevated creatine phosphokinase levels (CPK). Drug-induced RM is aetiologically significant. This case report describes a 25-year-old male who developed severe RM and Acute Kidney Injury (AKI) after intramuscular (IM) heroin administration as a first time user. IM heroin use can induce higher CPK levels due to direct myocyte toxicity and mechanical trauma. The highly vascularised gluteal muscles with type 1 fibres at the injection site likely exacerbated the severity. Additional factors included lower mitochondrial density in males and alcohol exposure. Despite aggressive fluid resuscitation, renal replacement therapy (RRT) was required, and the patient responded well to haemodialysis. This case highlights AKI as a severe complication of IM heroin use, underscoring the need for further research into drug-induced RM.</description><identifier>ISSN: 2053-8855</identifier><identifier>EISSN: 2053-8855</identifier><identifier>DOI: 10.1093/omcr/omae134</identifier><identifier>PMID: 39575092</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Case Report ; Creatine ; Creatine kinase ; Muscles ; Rhabdomyolysis</subject><ispartof>Oxford Medical Case Reports, 2024-11, Vol.2024 (11), p.omae134</ispartof><rights>The Author(s) 2024. Published by Oxford University Press. 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press.</rights><rights>COPYRIGHT 2024 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c371t-103a31fb97a47b353cfa1fd6d9de9f5636625e781a5de771d17336972d245d83</cites><orcidid>0009-0009-0262-1082 ; 0000-0002-0822-9454</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576553/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576553/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1598,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39575092$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dimov, Nikolay</creatorcontrib><creatorcontrib>Sultana, Tahsin</creatorcontrib><creatorcontrib>Dafeeah, Aishah</creatorcontrib><creatorcontrib>Choudhury, Hafsa</creatorcontrib><creatorcontrib>Nikolov, Dimitar</creatorcontrib><title>Intramuscular heroin-induced severe rhabdomyolysis and acute kidney injury—a case report</title><title>Oxford Medical Case Reports</title><addtitle>Oxf Med Case Reports</addtitle><description>Abstract
Rhabdomyolysis (RM) is characterised by the breakdown of skeletal muscle tissue, releasing toxic intracellular components into circulation. It presents with dark urine, muscle weakness, myalgia, and elevated creatine phosphokinase levels (CPK). Drug-induced RM is aetiologically significant. This case report describes a 25-year-old male who developed severe RM and Acute Kidney Injury (AKI) after intramuscular (IM) heroin administration as a first time user. IM heroin use can induce higher CPK levels due to direct myocyte toxicity and mechanical trauma. The highly vascularised gluteal muscles with type 1 fibres at the injection site likely exacerbated the severity. Additional factors included lower mitochondrial density in males and alcohol exposure. Despite aggressive fluid resuscitation, renal replacement therapy (RRT) was required, and the patient responded well to haemodialysis. This case highlights AKI as a severe complication of IM heroin use, underscoring the need for further research into drug-induced RM.</description><subject>Case Report</subject><subject>Creatine</subject><subject>Creatine kinase</subject><subject>Muscles</subject><subject>Rhabdomyolysis</subject><issn>2053-8855</issn><issn>2053-8855</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNp9kcFOHSEUholpo8a6c93Mrl10LMwZhmHVGFNbE5NuXLkhXDjjxc7ALQwms_Mh-oR9Erm5t8ZuGhIg8J0PTn5Czhg9Z1TC5zCZWCaNDNoDctxQDnXfc_7m1f6InKb0QCll0DHo-0NyBJILTmVzTO6u_Rz1lJPJo47VGmNwvnbeZoO2SviIEau41isbpiWMS3Kp0t5W2uQZq5_Oelwq5x9yXP48_daV0anwuAlxfkfeDnpMeLpfT8jt1dfby-_1zY9v15cXN7UBweaaUdDAhpUUuhUr4GAGzQbbWWlRDryDrms4ip5pblEIZpkA6KRobNNy28MJ-bLTbvJqQmtw29CoNtFNOi4qaKf-vfFure7Do2KMi45zKIaPe0MMvzKmWU0uGRxH7THkpIAB63lLxfax8x16r0dUzg-hKE0ZFidngsfBlfOLnkkBrWx5Kfi0KzAxpBRxePkYo2obodpGqPYRFvz962Ze4L-BFeDDDgh583_VM_NZqRw</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Dimov, Nikolay</creator><creator>Sultana, Tahsin</creator><creator>Dafeeah, Aishah</creator><creator>Choudhury, Hafsa</creator><creator>Nikolov, Dimitar</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0009-0009-0262-1082</orcidid><orcidid>https://orcid.org/0000-0002-0822-9454</orcidid></search><sort><creationdate>202411</creationdate><title>Intramuscular heroin-induced severe rhabdomyolysis and acute kidney injury—a case report</title><author>Dimov, Nikolay ; Sultana, Tahsin ; Dafeeah, Aishah ; Choudhury, Hafsa ; Nikolov, Dimitar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c371t-103a31fb97a47b353cfa1fd6d9de9f5636625e781a5de771d17336972d245d83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Case Report</topic><topic>Creatine</topic><topic>Creatine kinase</topic><topic>Muscles</topic><topic>Rhabdomyolysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dimov, Nikolay</creatorcontrib><creatorcontrib>Sultana, Tahsin</creatorcontrib><creatorcontrib>Dafeeah, Aishah</creatorcontrib><creatorcontrib>Choudhury, Hafsa</creatorcontrib><creatorcontrib>Nikolov, Dimitar</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale Academic OneFile</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Oxford Medical Case Reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dimov, Nikolay</au><au>Sultana, Tahsin</au><au>Dafeeah, Aishah</au><au>Choudhury, Hafsa</au><au>Nikolov, Dimitar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intramuscular heroin-induced severe rhabdomyolysis and acute kidney injury—a case report</atitle><jtitle>Oxford Medical Case Reports</jtitle><addtitle>Oxf Med Case Reports</addtitle><date>2024-11</date><risdate>2024</risdate><volume>2024</volume><issue>11</issue><spage>omae134</spage><pages>omae134-</pages><issn>2053-8855</issn><eissn>2053-8855</eissn><abstract>Abstract
Rhabdomyolysis (RM) is characterised by the breakdown of skeletal muscle tissue, releasing toxic intracellular components into circulation. It presents with dark urine, muscle weakness, myalgia, and elevated creatine phosphokinase levels (CPK). Drug-induced RM is aetiologically significant. This case report describes a 25-year-old male who developed severe RM and Acute Kidney Injury (AKI) after intramuscular (IM) heroin administration as a first time user. IM heroin use can induce higher CPK levels due to direct myocyte toxicity and mechanical trauma. The highly vascularised gluteal muscles with type 1 fibres at the injection site likely exacerbated the severity. Additional factors included lower mitochondrial density in males and alcohol exposure. Despite aggressive fluid resuscitation, renal replacement therapy (RRT) was required, and the patient responded well to haemodialysis. This case highlights AKI as a severe complication of IM heroin use, underscoring the need for further research into drug-induced RM.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>39575092</pmid><doi>10.1093/omcr/omae134</doi><orcidid>https://orcid.org/0009-0009-0262-1082</orcidid><orcidid>https://orcid.org/0000-0002-0822-9454</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Case Report Creatine Creatine kinase Muscles Rhabdomyolysis |
title | Intramuscular heroin-induced severe rhabdomyolysis and acute kidney injury—a case report |
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