Rhabdomyolysis associated acute renal failure - Report of two fatal cases and a brief review of literature.

Siddhartha Das, Srinivas Bheemanathi Hanuman, Jhansi Lakshmi Mylapalli

Journal: Journal of forensic and legal medicine 2020;71():101941

PMID: 32342911

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Rhabdomyolysis is a potentially fatal condition which occurs due to skeletal muscle injury and classically presents with myalgia and red-brown coloured urine. Presence of excess myoglobin in the glomerular filtrate forms myoglobin casts which causes severe obstruction and necrosis of the tubules leading to acute renal failure.

METHODS

We report two fatal cases of rhabdomyolysis associated acute renal failure. The first victim died in police custody and the second victim died due to severe physical exertion.

RESULTS

In both the cases, creatine kinase levels were elevated and myoglobin was detected in urine in the second case. Myoglobin immunohistochemistry detected the presence of myoglobin cast in the glomerular tubules of kidney in both the cases.

CONCLUSIONS

Myoglobin immunohistochemistry of renal tissues, serum creatine kinase, urine myoglobin analysis and muscle histopathology are the laboratory tests that should be considered at autopsy where rhabdomyolysis is suspected.

Address: Department of Forensic Medicine & Toxicology, JIPMER, Puducherry, India. Electronic address: [email protected].; Department of Pathology, JIPMER, Puducherry, India.; Department of Forensic Medicine & Toxicology, JIPMER, Puducherry, India.

DOI: 10.1016/j.jflm.2020.101941

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MeSH Terms: Acute Kidney Injury, Adult, Creatine Kinase, Fatal Outcome, Humans, Immunohistochemistry, Kidney Tubules, Male, Myoglobin, Myoglobinuria, Physical Exertion, Prisoners, Rhabdomyolysis, Wounds, Nonpenetrating, Young Adult