TY - JOUR
T1 - Acute Rhabdomyolysis Associated with Cocaine Intoxication
AU - Roth, David
AU - Alarcón, Francisco J.
AU - Fernandez, John A.
AU - Preston, Richard A.
AU - Bourgoignie, Jacques J.
PY - 1988/9/15
Y1 - 1988/9/15
N2 - 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.
AB - 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.
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U2 - 10.1056/NEJM198809153191103
DO - 10.1056/NEJM198809153191103
M3 - Article
C2 - 3412385
AN - SCOPUS:0023711380
VL - 319
SP - 673
EP - 677
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 11
ER -