Abstract
The objective of this retrospective cohort study was to evaluate demographic, clinical and laboratory characteristics of patients with rhabdomyolysis as defined by a serum creatine kinase (sCK) activity > 950 U/L. A total of 248 patients were recruited from the Department of Neurology, Medical University of Vienna, between 01/2000 and 12/2017, with a median sCK activity of 2,160 U/l (IQR 1,342–4,786). Seizures (31.9%), illicit drugs/alcohol (9.7%) and exercise (8.5%) were the most common trigger factors. Rhabdomyolysis incidence rates in specific neurological diseases as estimated by the ratio between rhabdomyolysis cases and the total number of cases with the corresponding disease were highest in myopathies (49.8/1,000 person-years, 95% CI 32.3–67.4), followed by epilepsy (16.4/1,000 person-years, 95% CI 12.8–20.0) and stroke (11.9/1,000 person-years, 95% CI 8.4–15.4). The half-life of sCK activity was 1.5 days in the total cohort. In myopathies, sCK activity was significantly higher as compared to other disease entities 7 days after the peak measurement (p = 0.0023). Acute kidney injury (AKI) developed in 18 patients (7.3%) with no AKI-related deaths during the study period. In conclusion, rhabdomyolysis occurred in a broad range of neurological entities but was associated with a favorable prognosis in most cases rarely resulting in AKI and death.
Highlights
Rhabdomyolysis is a serious and potentially lifethreatening condition frequently associated with neuromuscular diseases [1,2] and reported to occur in a broad range of other neurological diseases including seizures [3], cerebral ischemia [4], multiple sclerosis [5] and neuromyelitis optica [6]
A total of 248 patients with rhabdomyolysis were identified during the study period with a median age of 49.6 years (IQR 30.5–66.8) and males accounting for 60.5% of the cohort (Table 1)
In relation to the total number of patients with specific diagnoses treated in the hospital, the rhabdomyolysis incidence rate was highest in myopathies (49.8/1,000 person-years, 95% confidence intervals (CI) 32.3–67.4) followed by epilepsy (16.4/1,000 person-years, 95% CI 12.8–20.0), stroke (11.9/1,000 person-years, 95% CI 8.4–15.4), multiple sclerosis (6.7/1,000 person-years, 95% CI 3.3–10.1) and polyneuropathies (4.1/1,000 person-years, 95% CI 2.3–6.0) (Table 4)
Summary
Rhabdomyolysis is a serious and potentially lifethreatening condition frequently associated with neuromuscular diseases [1,2] and reported to occur in a broad range of other neurological diseases including seizures [3], cerebral ischemia [4], multiple sclerosis [5] and neuromyelitis optica [6]. Toxic stress inducing increased permeability or disruption of the muscle plasma membrane. This allows creatine kinase and other intracellular components to leak from muscle fibers into the extracellular space, from where they are taken up by the lymphatic system and enter the circulation. Serum creatine kinase (sCK) activity begins to rise within 2–12 h, peaks at 3–5 days after the injury, and declines over the subsequent 6–10 days [8]. Serum CK activity is commonly used as a biomarker for muscle fiber damage in routine diagnostic assays [9], with rhabdomyolysis defined as an increase of sCK activity above 5 times the upper limit of normal (ULN) in most studies [10 , 11]. We aimed to systematically characterize patients with rhabdomyolysis treated at a tertiary neurological center, and to evaluate various demographic and clinical parameters and model the time course of sCK activity for common neurological diseases
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
