Elsevier

The Journal of Emergency Medicine

Volume 15, Issue 6, November–December 1997, Pages 833-837
The Journal of Emergency Medicine

Severe rhabdomyolysis with renal failure after intranasal cocaine use

https://doi.org/10.1016/S0736-4679(97)00193-5Get rights and content

Abstract

A case of acute renal failure due to rhabdomyolysis in a patient who used cocaine on a daily basis is presented. In contrast to many prior reports of renal failure occurring with cocaine-associated rhabdomyolysis, our patient did not use intravenous cocaine and did not have any evidence of trauma, seizure, hypotension, hyperthermia, hyperactivity, or coma. His creatine phosphokinase peaked at 448,000 U/liter. He was treated initially with forced diuresis and i.v. furosemide, but he became oliguric, developed pulmonary edema, and required hemodialysis. He recovered fully after 3 weeks of dialysis. The literature is reviewed in an attempt to delineate a rational approach to evaluating cocaine users at risk for rhabdomyolysis.

References (40)

  • GA Brazeau et al.

    Effects of cocaine on leakage of creatine kinase from skeletal muscle: In vitro and in vivo studies in mice

    Life Sci

    (1995)
  • RD Welch et al.

    Incidence of cocaine associated rhabdomyolysis

    Ann Emerg Med

    (1991)
  • RW Derlet et al.

    Emergency department presentation of cocaine intoxication

    Ann Emerg Med

    (1989)
  • SL Brody et al.

    Cocaine-related medical problems: Consecutive series of 233 patients

    Am J Med

    (1990)
  • PA Gabow et al.

    The spectrum of rhabdomyolysis

    Medicine

    (1982)
  • KS Merigan et al.

    Cocaine intoxication: Hyperpyrexia, rhabdomyolysis and acute renal failure

    J Toxicol Clin Toxicol

    (1987)
  • PC Singhal et al.

    Rhabdomyolysis and acute renal failure associated with cocaine abuse

    J Toxicol Clin Toxicol

    (1990)
  • PI Menashe et al.

    Hyperthermia, rhabdomyolysis, and myoglobinuric renal failure after recreational cocaine use

    Southern Med J

    (1988)
  • V Anand et al.

    Cocaine associated rhabdomyolysis and acute renal failure

    Southern Med J

    (1989)
  • BC Herzlich et al.

    Rhabdomyolysis related to cocaine abuse

    Ann Intern Med

    (1988)
  • Cited by (36)

    • Overdose of cardiotoxic drugs

      2018, Cardiac Intensive Care
    • Mechanism-based therapeutic approaches to rhabdomyolysis-induced renal failure

      2011, Free Radical Biology and Medicine
      Citation Excerpt :

      Lysis of myocytes can also occur after ischemia [17–20] or be caused by metabolic disorders leading to hypokalemia, hypernatremia, or hypophosphatemia [21–26]. Many drugs administered in overdose, but also via chronic normal dose administration, have been shown to cause rhabdomyolysis [27–45]. Finally, genetic disorders leading to deregulation of enzymes involved in metabolic pathways have also been linked to rhabdomyolysis [46–50].

    • Overdose of cardiotoxic drugs

      2010, Cardiac Intensive Care: Expert Consult
    • Overdose of Cardiotoxic Drugs

      2010, Cardiac Intensive Care
    View all citing articles on Scopus
    View full text