Clinical spectrum of psychiatric patients with rhabdomyolysis

Abstract

Objective Rhabdomyolysis is a potentially life-threatening syndrome that can develop from various causes. This study was undertaken to analyse the clinical spectrum and to evaluate the prevalence of various aetiologies in psychiatric patients with rhabdomyolysis. Methods We retrospectively analysed the medical charts of 87 patients. For them, serum creatine kinase (SCK) activity higher than 1500 IU/l was defined as rhabdomyolysis. The causes of increased SCK activity were assessed. Results The annual incidence of rhabdomyolysis during 2007–2012 was 0.8–1.45%. In 59 men and 28 women (17–87 years old; median 50.9 years), no relation was found between age and the highest value of SCK activity. Their SCK activities were 1544–186 500 IU/l (median 3566 IU/l), but 45% had SCK activity higher than 5000 IU/l. Men were at greater risk than women. Major aetiologic factors were medical drugs, excessive physical activity, and psychogenic polydipsia. Patients with psychogenic polydipsia and alcoholism had higher SCK activity. Acute kidney injury (AKI) occurred in 8 men (9.1%). Five patients died, but only one died of rhabdomyolysis. Conclusions Most psychiatric patients with rhabdomyolysis were asymptomatic. The increase in SCK activity subsided spontaneously without specific treatment.