Acute Compartment Syndrome: Clinical Course and Laboratory Findings in Pregnant Patients with McArdle's Disease

Abstract

Dear Editor, Patients with McArdle's disease are often diagnosed secondary to exercise intolerance, myalgia, fatigue, poor endurance, and muscle swelling, among other symptoms. In these patients, the resting serum creatine kinase (CK) levels are known to be elevated. There is little information regarding the effects of labor and delivery on the disease. We would like to report our experience in patients with McArdle's disease that were followed during their pregnancy and in the peripartum period. Following delivery, one of the patients developed sudden severe ankle pain which was consistent with and subsequently confirmed as acute compartment syndrome. The rise in serum creatine kinase by itself was not diagnostic of postpartum compartment complication but when combined with clinical findings, the condition was recognized and treated. McArdle's disease is a genetic condition that is predominantly passed in an autosomal recessive fashion [1,2]. Patients with McArdle's disease have inadequate amounts of skeletal muscle specific glycogen phosphorylase, myophosphorylase which subsequently leads to elevation in CK levels [1,3,4]. These patients suffer from exercise intolerance characterized during anaerobic activities and intense aerobic activities [1,3,4]. A high-resting serum CK level after demanding physical exertion is characteristic of McArdle's disease [1]. A diet consisting mostly of complex carbohydrates in …