medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2023, Number 11

<< Back Next >>

Ginecol Obstet Mex 2023; 91 (11)

Rhabdomyolysis associated with hypokalemia in pregnancy and perinatal aspects. A case report

Galván LA, Rivas LR

Language: Spanish
References: 15
Page: 840-846
PDF size: 212.19 Kb.


ABSTRACT

Background: Rhabdomyolysis is a syndrome, caused by injury to the muscle fiber, which produces the release of intracellular components such as myoglobin, creatine kinase, aldolase and lactate dehydrogenase, electrolytes, into the extracellular space and blood circulation, which can cause serious complications. such as cardiovascular disorders, cerebral edema and death. There are few reported cases of rhabdomyolysis in pregnancy, the reports described in the literature have been associated with infections and hydroelectrolytic changes. The clinical case is presented due to the importance of the repercussion to the maternal-fetal binomial, since it can result in a serious outcome.
Clinical case: The case of a primiparous pregnant patient is presented, who debuted with clinical symptoms accompanied by muscular alterations after an infection, in week 18 of gestation, for which a study protocol was requested with the finding of hydroelectrolyte imbalance, of the hypokalemia type, with sudden elevation of creatine phosphokinase. A positive urine culture for Escherichia coli was found. Management with hydroelectrolyte replacement was indicated, with potassium replacement adjusted to requirements, antibiotic, and nutritional contribution, with hospital discharge after 2 days. Prenatal control was continued and at week 32.2 she presented preeclampsia, which is why a cesarean section was decided, a male weighing 2395 g, Apgar 9/9, with satisfactory evolution of the binomial was obtained.
Conclusions: Pregnancy is more susceptible to infections or complications associated with hydroelectrolyte imbalances, rhabdomyolysis can occur in pregnancy, and it is important not to rule it out, its diagnosis can be made clinically and through laboratory tests.


REFERENCES

  1. Gupta A, Thorson P, Penmatsa KR, Gupta P. Rhabdomyolysis:Revisited. Ulster Med J 2021; 90 (2): 61-69. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278949/pdf/umj-90-02-61.pdf

  2. Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis:pathogenesis, diagnosis, and treatment. OchsnerJ 2015; 15 (1): 58-69. https://www.ochsnerjournal.org/content/ochjnl/15/1/58.full.pdf

  3. Kondo T, Nakamura M, Kawashima J, Matsumura T,et al. Hyperemesis gravidarum followed by refeedingsyndrome causes electrolyte abnormalities inducedrhabdomyolysis and diabetes insipidus. Endocrine J 2019;66; 3: 253-258. https://www.jstage.jst.go.jp/article/endocrj/66/3/66_EJ18-0496/_pdf

  4. Cortés R, Kleinsteuber K, Vargas CP, Avaria MD. Rabdomiólisismetabólica: actualización. Rev Méd Clín LasCondes 2018; 29 (5): 553-559. https://doi.org/10.1016/j.rmclc.2018.08.003

  5. Kishkovich TP, Lu CF, Hardy EJ, Russo ML. A presentationof adenovirus with hypokalemia and rhabdomyolysisin pregnancy. Obstet Med 2022; 15 (1): 59-61. DOI:10.1177/1753495x20970790.

  6. Muthukrishnan J, Harikumar K, Jha R, Modi K. Pregnancypredisposes to rhabdomyolysis due to hypokalemia. SaudiJ Kidney Dis Transpl 2010; 21 (6): 1127-8. file:///C:/Users/pc/Downloads/pregnancy_predisposes_to_rhabdomyolysis_due_to.19.pdf

  7. Carminati G, Chena A, Orlando JM, Russo S, et al. Distal renaltubular acidosis with rhabdomyolysis as the presentingform in 4 pregnant women. Nefrol 2001; 21 (2): 204-208.https://www.revistanefrologia.com/es-acidosis-tubularrenal-distal-con-articulo-X0211699501013208

  8. Momoh R. Rhabdomyolysis and Obstetric Correlates: LiteraturePerspectives for the Obstetric Anesthesiologist. EurJ Med Health Sci 2021; 3 (6): 1-3. https://doi.org/10.24018/ejmed.2021.3.6.1098

  9. Knochel JP, Schlein EM. On the mechanism of rhabdomyolysisin potassium depletion. J Clin Invest 1972; 51 (7):1750-1758. https://doi.org/10.1172/JCI106976.

  10. Nance JR, Mammen AL. Diagnostic evaluation of rhabdomyolysis.Muscle Nerve 2015; 51: 793-810. DOI: 10.1002/mus.24606.

  11. Zutt R, van der Kooi AJ, Linthorst GE, Wanders RJ, et al.Rhabdomyolysis: review of the literature. Neuromuscul Disord2014; 24 (8): 651-9. DOI: 10.1016/j.nmd.2014.05.005.

  12. Kourtis AP, Read JS, Jamieson DJ. Pregnancy and Infection.New Eng J Med 2014; 370 (23): 2211-2218. DOI: 10.1056/nejmra1213566.

  13. Srisuttayasathien M. Hypokalemia-Induced Rhabdomyolysisas a result of Distal Renal Tubular Acidosis in aPregnant Woman: A Case Report and Literature Review.Case Rep Obstet Gynecol 2015; 2015: 947617. DOI:10.1155/2015/947617

  14. Lassey SC, Robinson JN. Rhabdomyolysis After HyperemesisGravidarum. Obstet Gynecol 2016; 128 (1): 195-196. DOI:10.1097/AOG.0000000000001418. PMID: 27275790.

  15. Yürük D, Yılmaz A, Özgencil GE, Aşık İ. Acute rhabdomyolysisfollowing epidural steroid injection: An unusual complicationin a patient with low back pain. Agri 2019; 31 (3):150-152. DOI: 10.5505/agri.2017.54366.




2020     |     www.medigraphic.com