Exertional Rhabdomyolysis: A Case of Markedly Elevated Creatine Kinase Without Acute Kidney Injury

Abstract

Rhabdomyolysis describes a clinical syndrome in which striated muscle breaks down and intracellular contents are released into the circulation. Exertional rhabdomyolysis can be caused by a new, intense workout routine or a change in intensity of an existing one. The severity of presentation varies from asymptomatic creatine kinase (CK) elevations to life-threatening renal failure, disseminated intravascular coagulation, cardiac dysrhythmias and/or compartment syndrome. Our case describes a patient with exertional non-traumatic rhabdomyolysis caused by a mild workout routine change with markedly elevated CK level. There was no evidence of any concomitant renal failure or other aberrancies, such as compartment syndrome, electrolyte abnormalities or electrocardiogram changes. Although the patient reports this as his initial episode of such symptoms, inherited metabolic disorders and genetic mutations should be considered and further workup performed. To the best of our knowledge, this is a rare case of a significantly elevated CK resulting from modest exercise that did not result in acute kidney injury. J Med Cases. 2014;5(9):483-485 doi: http://dx.doi.org/10.14740/jmc1792w