Rhabdomyolysis and acute renal failure after gardening.

Zeljko Vucicevic

doi:10.1155/2015/174892

Abstract

Acute nontraumatic exertional rhabdomyolysis may arise when the energy supply to muscle is insufficient to meet demands, particularly in physically untrained individuals. We report on a psychiatric patient who developed large bruises and hemorrhagic blisters on both hands and arms, rhabdomyolysis of both forearm muscles with a moderate compartment syndrome, and consecutive acute renal failure following excessive work in the garden. Although specifically asked, the patient denied any hard physical work or gardening, and heteroanamnestic data were not available. The diagnosis of rhabdomyolysis was easy to establish, but until reliable anamnestic data were obtained, the etiology remained uncertain. Four days after arrival, the patient recalled working hard in the garden. The etiology of rhabdomyolysis was finally reached, and the importance of anamnestic data was once more confirmed.

Highlights

We report on a psychiatric patient who developed large bruises and hemorrhagic blisters on both hands and arms, rhabdomyolysis of both forearm muscles with a moderate compartment syndrome, and consecutive acute renal failure following excessive work in the garden
Acute nontraumatic exertional rhabdomyolysis may arise in individuals with normal muscles when the energy supply to muscles insufficiently meets demands [1]
We report on a psychiatric patient who developed large bruises and hemorrhagic blisters on both hands and arms, rhabdomyolysis of both forearm muscles with a moderate compartment syndrome, and a consecutive acute renal failure following excessive work in the garden

Summary

Introduction

Acute nontraumatic exertional rhabdomyolysis may arise in individuals with normal muscles when the energy supply to muscles insufficiently meets demands [1]. Examples usually include ultramarathon races which may be aggravated by extremely hot, humid conditions in physically untrained individuals [2]. Friction blisters on the palms and fingers frequently follow vigorous physical work or repetitive physical activities causing detachment of the skin epidermis. Particular areas of the skin can be entirely detached from the basis and blisters filled with blood. We report on a psychiatric patient who developed large bruises and hemorrhagic blisters on both hands and arms, rhabdomyolysis of both forearm muscles with a moderate compartment syndrome, and a consecutive acute renal failure following excessive work in the garden

Case Report

Discussion