Rhabdomyolysis in Acute Spinal Cord Injury Presenting With Nausea and Vomiting as Chief Complaints: A Case Report

Annals of Rehabilitation Medicine, 2014 · DOI: http://dx.doi.org/10.5535/arm.2014.38.4.559 · Published: August 1, 2014

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

Rhabdomyolysis is a condition caused by muscle damage that leads to the release of harmful substances into the blood, potentially causing kidney failure. This case report describes a patient with acute spinal cord injury who developed rhabdomyolysis but did not have typical symptoms like muscle pain. Instead, she experienced nausea and vomiting. The doctors recommend that clinicians regularly check creatine kinase (CK) levels in SCI patients to detect rhabdomyolysis early, even when typical symptoms are absent, to prevent kidney damage.

Study Duration

Not specified

Participants

A 34-year-old female patient

Evidence Level

Case Report

Key Findings

1
The patient with acute spinal cord injury presented with rhabdomyolysis, but the primary symptoms were nausea and vomiting, not the typical muscle pain or dark urine.
2
Rhabdomyolysis was diagnosed based on elevated creatine kinase (CK) and myoglobin levels, along with tea-colored urine, even without apparent muscular injury or soft tissue damage.
3
Intravenous saline treatment normalized urine color and resolved nausea and vomiting, and kidney damage was prevented with early diagnosis and treatment.

Research Summary

This case report describes rhabdomyolysis in a spinal cord injury patient presenting with nausea and vomiting. Early diagnosis of rhabdomyolysis through regular creatine kinase level checks can help prevent acute renal failure in SCI patients. The cause of rhabdomyolysis in this case was likely due to immobilization resulting in subclinical compressive ischemia of muscle.

Practical Implications

Increased Awareness

Clinicians should consider rhabdomyolysis as a potential cause of unexplained nausea and vomiting in SCI patients, even in the absence of typical symptoms.

Regular Monitoring

Regular creatine kinase (CK) level checks are recommended for SCI patients to enable early diagnosis and treatment of rhabdomyolysis.

Preventive Hydration

Early diagnosis and intensive hydration can help preserve renal function and prevent acute renal failure in SCI patients with rhabdomyolysis.

Study Limitations

1
Single case report limits generalizability.
2
The exact cause of rhabdomyolysis in this case is not definitively proven; only suspected.
3
Lack of a control group to compare outcomes.

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