On February 27, Hue Central Hospital announced that its doctors and nurses had successfully treated and discharged a child with a rare disease called acute rhabdomyolysis. That was the case of Tran Gia H. (15 years old, residing in Huong Tra town, Thua Thien Hue province).
H. was admitted to the hospital on January 30 with symptoms of fatigue, body aches, and cola-colored urine. The patient had a high fever, muscle pain, weakness in the limbs, and an infected appearance. Initial blood tests showed that H. had severe sepsis and multiple organ damage, mainly the liver and kidneys. This is a condition of infectious disease, with acute kidney damage with red urine, dark urine, and high levels of red blood cells and protein in the urine, and the classic triad of rhabdomyolysis was very clear. The patient was diagnosed with severe, life-threatening acute rhabdomyolysis.
Child H. (red shirt) and the medical team before being discharged from the hospital
Tests showed clear rhabdomyolysis with very high creatinine kinase (449375 U/L), high myoglobin levels in the blood and urine, kidney and liver damage with progressive lung damage and systemic inflammatory response syndrome. The Pediatric Intensive Care Unit, Pediatric Center, Hue Central Hospital quickly consulted and conducted treatment according to the acute rhabdomyolysis treatment regimen (fluid infusion, urine alkalinization, electrolyte imbalance correction), antibiotics to treat infections, intravenous corticosteroids, close clinical monitoring, etc.
Hue Central Hospital said that the treatment process encountered many difficulties because the child showed signs of septic shock, progressive acute kidney injury, in which acute renal tubular injury caused polyuria, activation of the renin-angiotensin system and sympathetic system caused severe hypertension, tachycardia, electrolyte disturbances, severe liver damage, and progressive lung damage requiring the use of advanced techniques such as non-invasive mechanical ventilation.
After 7 days of intensive treatment, the child's fever subsided, the infection, lung and liver damage improved, urine gradually faded and returned to normal, but blood pressure was not stable. The patient was discharged from the intensive care unit and continued treatment at the Department of Pediatric Neurology - Autism - Nephrology - Endocrinology of the Children's Center. After more than 1 month, blood pressure and test indicators for infection, organ function, and urine returned to normal levels and he was discharged from the hospital.
Acute rhabdomyolysis is a rare syndrome in children. This disease is understood as a condition of skeletal muscle cell destruction, releasing into the blood components of destroyed muscle cells such as myoglobin, potassium, phosphorus, uric acid, creatinine kinase, AST, ALT..., causing complications, such as acute kidney injury; electrolyte disturbances; compartment syndrome, and disseminated intravascular coagulation. The incidence of secondary rhabdomyolysis is 5-8%, the mortality rate is about 10% if not treated promptly. Acute kidney injury is a common serious complication of rhabdomyolysis, about 13-46% of patients with rhabdomyolysis have acute kidney injury. And acute kidney injury is the leading cause of death in patients with rhabdomyolysis...
S. THUY
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