Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

13 September 2022 : Case report  USA

[In Press] Physiologic Response to Exercise or Rhabdomyolysis? Creatine Phosphokinase Elevation in 16 Asymptomatic Firefighters

Unusual clinical course, Challenging differential diagnosis

Rajia Arbab12ABCDEF, Carla Erb12BCDE, Justin Joy2E, Hanady Zainah2EG, Majed Mark Samarneh3BEG

DOI: 10.12659/AJCR.937084

Am J Case Rep In Press; DOI: 10.12659/AJCR.937084  

Available online: 2022-09-13, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
We present a case series of 16 trainee firefighters who presented to the Emergency Department with elevated creatine phosphokinase levels of greater than 14 000 units per liter 3 days after the initiation of intense aerobic exercise. All 16 patients were diagnosed with exercise-induced rhabdomyolysis and were mostly asymptomatic. While exercise-induced rhabdomyolysis often affects untrained individuals who abruptly initiate strenuous exercises, our patients were all physically well-trained and maintained an active training regimen. In review of this unusual case series, we assess the patients’ risk factors for exercise-induced rhabdomyolysis and the complications of their elevated creatine phosphokinase levels despite their asymptomatic presentations.
CASE REPORT
We focus on the exercise routine, hospital admission, and course of treatment for 4 of the 16 patients who gave written consent to participate in the study. Therapy was targeted towards intravenous fluids and the lowering of creatine phosphokinase levels. Patients 1, 2, 3, and 4 were discharged when creatine phosphokinase levels decreased by 17%, 40%, 39%, and 40%, respectively.
CONCLUSIONS
Given the differing guidelines for diagnosis, treatment, and discharge for asymptomatic exercise-induced rhabdomyolysis, it was unclear if this was a physiologic or pathologic response to exercise, if hospital admission was indicated, and the extent to which creatine phosphokinase had to decrease for discharge. Our aim is to: 1) determine recommendations to prevent muscle injury following exercise, 2) distinguish between physiologic response to exercise and clinically significant muscle damage, and 3) and recommend a course of treatment given asymptomatic presentation.

Keywords: Acute Kidney Injury; Rhabdomyolysis; Sports Medicine

SARS-CoV-2/COVID-19

22 September 2022 : Case report  USA

Rare Case of Persistently Depressed T Lymphocyte Subsets After SARS-CoV-2 Infection

Am J Case Rep In Press; DOI: 10.12659/AJCR.937760  

22 September 2022 : Case report  Poland

Central Retinal Vein Occlusion After Discontinuation of Rivaroxaban Therapy in a Young Patient with COVID-1...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937739  

19 September 2022 : Case report  Spain

Inhaled Nitric Oxide in Acute Severe Pulmonary Hypertension and Severe Acute Respiratory Distress Syndrome ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937147  

14 September 2022 : Case report  Japan

Case Report: A 29-Year-Old Pregnant Woman at 24 Weeks of Gestation Presenting with Laryngotracheitis and CO...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937834  

In Press

27 Sep 2022 : Case report  Slovenia

Compound Heterozygote Mutation in the SMPD1 Gene Leading to Nieman-Pick Disease Type A

Am J Case Rep In Press; DOI: 10.12659/AJCR.937220  

26 Sep 2022 : Case report  Saudi Arabia

An Infant Presenting with Interstitial Lung Disease Diagnosed Later as Hunter Syndrome: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.937527  

26 Sep 2022 : Case report  Thailand

Acute Intermittent Porphyria: Complete Phenotype in a Patient with p.Arg173Trp Variant in Thailand

Am J Case Rep In Press; DOI: 10.12659/AJCR.937695  

26 Sep 2022 : Case report  USA

Injury to the Posterior Horn of the Lateral Meniscus from a Misplaced Tibial Tunnel for Anterior Cruciate L...

Am J Case Rep In Press; DOI: 10.12659/AJCR.937581  

Most Viewed Current Articles

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

17 Feb 2022 : Case report  Oman

Myocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...

DOI :10.12659/AJCR.934399

Am J Case Rep 2022; 23:e934399

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923