Acute rhabdomyolysis associated with cocaine intoxication

David Roth, F. J. Alarcon, J. A. Fernandez, Richard A Preston, J. J. Bourgoignie

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Abstract

Because an increasing number of patients were arriving at our emergency room with cocaine intoxication and rhabdomyolysis, we reviewed our experience with such patients. We identified 39 patients seen at our institution over an eight-year period with acute rhabdomyolysis after cocaine use. The patients' mean creatine kinase level was 12,187 U per liter (range, 1756 to 85,000). Thirteen of the 39 patients (33 percent) had acute renal failure; 6 of them died. In comparison to the patients with normal renal function, those with renal failure were more often admitted with profound hypotension (46 vs. 4 percent; P < 0.001), hyperpyrexia (69 vs. 15 percent; P < 0.001), and markedly elevated serum creatine kinase levels (mean, 28,084 vs. 7931 U per liter; P < 0.01). Disseminated intravascular coagulation developed in seven patients with renal failure. All six deaths were in this group. Severe hepatic dysfunction was found in 11 patients with renal failure. We conclude that cocaine intoxication can cause acute rhabdomyolysis with acute renal failure, severe liver dysfunction, and disseminated intravscular coagulation and that the mortality rate among patients with this syndrome is high.

Original languageEnglish
Pages (from-to)673-677
Number of pages5
JournalNew England Journal of Medicine
Volume319
Issue number11
StatePublished - Jan 1 1988

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Rhabdomyolysis
Cocaine
Renal Insufficiency
Creatine Kinase
Acute Kidney Injury
Disseminated Intravascular Coagulation
Hypotension
Hospital Emergency Service
Liver Diseases
Kidney
Mortality
Liver

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Roth, D., Alarcon, F. J., Fernandez, J. A., Preston, R. A., & Bourgoignie, J. J. (1988). Acute rhabdomyolysis associated with cocaine intoxication. New England Journal of Medicine, 319(11), 673-677.

Acute rhabdomyolysis associated with cocaine intoxication. / Roth, David; Alarcon, F. J.; Fernandez, J. A.; Preston, Richard A; Bourgoignie, J. J.

In: New England Journal of Medicine, Vol. 319, No. 11, 01.01.1988, p. 673-677.

Research output: Contribution to journalArticle

Roth, D, Alarcon, FJ, Fernandez, JA, Preston, RA & Bourgoignie, JJ 1988, 'Acute rhabdomyolysis associated with cocaine intoxication', New England Journal of Medicine, vol. 319, no. 11, pp. 673-677.
Roth D, Alarcon FJ, Fernandez JA, Preston RA, Bourgoignie JJ. Acute rhabdomyolysis associated with cocaine intoxication. New England Journal of Medicine. 1988 Jan 1;319(11):673-677.
Roth, David ; Alarcon, F. J. ; Fernandez, J. A. ; Preston, Richard A ; Bourgoignie, J. J. / Acute rhabdomyolysis associated with cocaine intoxication. In: New England Journal of Medicine. 1988 ; Vol. 319, No. 11. pp. 673-677.
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