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- Title
Acute viral myositis: profound rhabdomyolysis without acute kidney injury.
- Authors
Kietaibl, Antonia-Therese; Fangmeyer-Binder, Maria; Göndör, Gabor; Säemann, Marcus; Fasching, Peter
- Abstract
Summary: Background: Acute viral myositis (AVM) may be triggered by influenza A/B, enteroviruses and other viruses. Severe complications including rhabdomyolysis regularly lead to acute kidney injury (AKI). The aim of this short report was to discuss management and differential diagnosis of massive creatine kinase (CK) elevation. Patient, material and methods: Herein, we report on a 19-year-old Austrian male of African descent with a history of respiratory tract infections and whole-body pain. He further developed acute viral myositis and massive CK elevation up to 440,000 IU/L but without any signs of AKI. A literature search relating AVM, management and differential diagnosis of rhabdomyolysis was conducted in PubMed and UptoDate. Results: A full panel of serological and autoimmune blood work-up including testing for human immunodeficiency virus (HIV), hepatitis, influenza A/B, Epstein-Barr virus (EBV), antinuclear antibodies (ANA) and autoantibodies against various extractable nuclear antigens (ENA) did not reveal evidence for viral originators or autoimmune diseases. This case indicates that in acute viral myositis associated with extreme CK elevation (>400,000 IU/L) AKI might be completely absent. Potential causes for this clinical phenotype, differential diagnosis and management are discussed.
- Subjects
ACUTE kidney failure; MYOSITIS; AUTOIMMUNE diseases; CHRONIC active hepatitis; RHABDOMYOLYSIS; RESPIRATORY infections; CREATINE kinase
- Publication
Wiener Klinische Wochenschrift, 2021, Vol 133, Issue 15/16, p847
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-021-01866-3