| خلاصه مقاله | Introduction. One of the consequences of poisoning is rhabdomyolysis,
a clinical syndrome that occurs due to the damage to striated muscles,
myocytes, muscular fibers, and the release of intercellular elements into the
bloodstream. Mechanisms causing this syndrome consist of damage to the
cell wall, cellular hypoxia, and disorders in the sodium-potassium pump
of muscle cells. This syndrome is caused by various factors, including the
consumption of some medicines and poisons, surgery, trauma, malignant
hyperthermia, muscular ischemia, high muscular stresses, impacting
physical factors, viral and bacterial infections, metabolic and electrolyte
disorders, endocrine disorders, genetic disorders, and neuropathies. This
study examined rhabdomyolysis in all types of poisoned hospitalized
patients and its relationship with paraclinical variables, such as creatine
phosphokinase and the patients’ level of creatinine, blood urea, alanine
aminotransferase, and aspartate aminotransferase.
Methods. In this retrospective cross-sectional study, the researchers
reviewed the records of all the patients hospitalized for poisoning
during one year and identified cases of rhabdomyolysis by referring
to patients’ records in a referral center in the northwest of Iran. More
than 100 patients suffering from rhabdomyolysis caused by poisoning
were enrolled.
Results. In this study, the frequency of AKI ranged from 10.9 to over 16.9
percent: at discharge (or death) (10.9%), during hospitalization (16.9%),
and arrival time (16.9%). There was a significantly positive correlation
between age and Cr; i.e., by aging, only Cr levels also increased at arrival
time (Pearson’s correlation: +0.248, P = 0.024). There was a significantly
positive correlation between CPK and Cr, i.e., with an increase in CPK
level, Cr levels increased, too, and with a decrease in CPK levels, Cr
levels decreased, too (Table 3). In CPK levels > 2000, the risk of AKI
(Cr > 1.5) increased 2.33 folds.
Conclusion. Xenobiotics (e.g., opioids, drugs, alcohol, and poisons),
xenobiotic-induced coma, and/or xenobiotic-induced seizures were
the causes of rhabdomyolysis in the present study. Briefly, the research
findings revealed the highest prevalence of rhabdomyolysis in male youth
poisoned by narcotics. This research indicates drug misuse of youth as
active labor forces and subsequently one of the severe social crises that
the authorities should monitor and control. Typical clinical symptoms
and rhabdomyolysis symptoms do not occur at the same time. Hence,
proper clinical workouts and timely para-clinical tests play a significant
role in the initial diagnosis and timely treatment to avoid ARF. |