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Suggest Treatment For Rhabdomyolysis

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Posted on Wed, 17 Dec 2014
Question: My son who is 21 was diagnosed with rhabdo in mid October. His CPK level was over 27000 when he was admitted to the hospital. The puzzling thing is that multiple doctors at the hospital said he should not have had it. While he had strained the muscle directly above his elbow during weight lifting on a Monday, it took until Friday for the area to become really swollen and tender. The doctors at the hospital said he had rhabdo but should not have had it because there was so much time between the injury and the occurrence of rhabdo. Do you think it is odd that it took five days to develop?
doctor
Answered by Dr. Anshul Varshney (3 hours later)
Brief Answer:
Unlikely after a small injury.

Detailed Answer:
Welcome back.
See, Rhabdomyolysis can occur after a muscle injury that can include exercises specially if done being dehydrated.
Now, the problem is that such high levels of CPK are very Unlikely to occur due to just a strained muscle injury during exercise.
This might be a coincidence or just an aggravating factor behind the Severe Rhabdomyolysis.
I would advise in such situations further investigatory workup that includes Muscle biopsy, Kidney Functions , Autoimmune Antibody panel.
I agree with your doctors that this high level of CPK is Unlikely to be due to strained muscle injury.
Infact at such high levels most important concern is to save the kidneys. I hope he is admitted and your doctors are working on that.
If possible for you, request your doctors to give a summary or his reports to you, which you can send me. I will study them and help you.
If you have any further query please ask me.
Stay Healthy.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anshul Varshney (23 minutes later)
He was admitted for four days in October and released when the CPK came down to 5000. He had a repeat CPK done 5 weeks after discharge and it was 154. He had kidney function tests done at the hospital and all came back normal. He also had a repeat urinalysis done last week and it too was normal.

He is going to see an autoimmune disorder doctor in two weeks.

This is all so puzzling because the doctors at the hospital diagnosed him with bicep tendonitis and lateral epicondylitis of the elbow. They said even though it was unusual for rhabdo to happen five days later, his occurance was a result of the breakdown of muscle in the elbow.

My question is do some people have a higher predisposition to develop rhabdo than others? And is there anything he can do in the future to avoid getting this?
doctor
Answered by Dr. Anshul Varshney (12 minutes later)
Brief Answer:
I suggest muscle biopsy.

Detailed Answer:
Dear Friend.
Its great he has actually recovered from the acute illness.
But yes your query is very genuine. What to be done to prevent further episodes.
As far as predisposition is considered yes, males are more predisposed. For prevention we need to find out the cause.
If we know the cause then we can prevent it.
If it is muscle injury related only then u would advise him to do light exercises and avoid to strain. Maintaining a good hydration during exercise is very important.
I also advise, muscle biopsy in case Autoimmune workout comes negative.
If you have any further query please ask me.
Stay Healthy.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anshul Varshney (1 minute later)
What is a muscle biopsy and what does it diagnose?
doctor
Answered by Dr. Anshul Varshney (7 minutes later)
Brief Answer:
To diagnose Polymyositis

Detailed Answer:
Dear Friend.
In muscle biopsy we take a piece of muscle fiber and examine it under microscope and study it.
This is either done to rule out hereditary myopathies and also conditions like Polymyositis.
However , I advise muscle biopsy only in this scenario if the Autoimmune workup is negative and suspicion for myopathies is very high.
If you have any further query please ask me.
Stay Healthy.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anshul Varshney (2 minutes later)
thank you for your help.

doctor
Answered by Dr. Anshul Varshney (2 minutes later)
Brief Answer:
Good Luck.

Detailed Answer:
I wish him a speedy recovery. And good health ahead.
When you get the Autoimmune panel reports, write to me again with the reports. You can reopen this discussion thread again.
If you have no further query, I would appreciate if you could close the query and write a review.
Stay Healthy.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Anshul Varshney

Internal Medicine Specialist

Practicing since :2009

Answered : 3071 Questions

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Suggest Treatment For Rhabdomyolysis

Brief Answer: Unlikely after a small injury. Detailed Answer: Welcome back. See, Rhabdomyolysis can occur after a muscle injury that can include exercises specially if done being dehydrated. Now, the problem is that such high levels of CPK are very Unlikely to occur due to just a strained muscle injury during exercise. This might be a coincidence or just an aggravating factor behind the Severe Rhabdomyolysis. I would advise in such situations further investigatory workup that includes Muscle biopsy, Kidney Functions , Autoimmune Antibody panel. I agree with your doctors that this high level of CPK is Unlikely to be due to strained muscle injury. Infact at such high levels most important concern is to save the kidneys. I hope he is admitted and your doctors are working on that. If possible for you, request your doctors to give a summary or his reports to you, which you can send me. I will study them and help you. If you have any further query please ask me. Stay Healthy.