Main Article Content

Abstract

RÉSUMÉ
Introduction. La rhabdomyolyse est la perte de l’intégrité des muscles striés squelettiques occasionnant la libération de son contenu dans la circulation sanguine (créatine phospho-kinases [CPK], myoglobine, enzyme et ions). Les formes non traumatiques de ce syndrome clinico biologique  répondent à des mécanismes variés (métabolique, toxique, infectieux …). Le but du travail était de décrire les aspects clinques et paracliniques de cette entité à Bamako. Méthodologie. Il s’agissait d’une étude descriptive avec recueil prospectif des données cliniques, biologiques sur 30 mois allant du 1er janvier 2017 au 31 Mars 2018 en neurologie du CHU Point de Bamako.  Résultats. Nous avons colligé 10 patients répondant aux critères de rhabdomyolyse non traumatique. Leur âge moyen était de 33 ans avec des extrêmes allant de 16 à 63 ans. Le sexe féminin était prédominant avec un sex ratio 1/9. La faiblesse musculaire aigue ou subaiguë constituait le motif d’hospitalisation le plus fréquent (80%). Le facteur déclenchant était dominé par les vomissements gravidiques dans 70%. L’évolution a été marquée par la guérison sans séquelle dans 90% des cas malgré un taux de 30% d’insuffisance rénale aigue. Le taux de mortalité était de 10%. Conclusion.  Ce travail  attire l’attention sur une affection probablement  sous diagnostiquée, car peu  évoquée, avec comme conséquence une absence de dosage de CPK , examen clé du diagnostic. Le respect des règles de bonnes pratiques médicales simples permet d’éviter des complications parfois désastreuses (insuffisance rénale, décès…).

ABSTRACT
Introduction. Rhabdomyolysis is defined as the loss of the integrity of the skeletal striated muscles causing the release of its contents into the bloodstream (creatine phospho-kinases, myoglobin, enzymes and ions). The non-traumatic forms of this clinical biological syndrome respond to various mechanisms (metabolic, toxic, infectious, etc.). The aim of our work was to describe epidemiology and clinical features of this disease in Bamako. Methodology. This was a descriptive study with prospective collection of clinical, biological data over 30 months from January 1, 2017 to March 31, 2018. Results. We studied ten patients meeting the criteria of non-traumatic rhabdomyolysis. There were nine women and one man. The average age was 33 with extremes ranging from 16 to 63. Acute or sub acute muscle weakness was the most common reason for hospitalization (80%). The most common triggering factor was pregnancy vomiting (70%). The evolution was marked by recovery without sequel in 90% despite 30% rate of acute renal failure. The mortality rate was 10%. Conclusion. Non-traumatic rhabdomyolysis is probably underdiagnosed, because practitioners do not evoke the disease and consequently do not request CPK assays.  By implementing simple, affordable good medical practice rules, rhabdomyolysis and its possible disastrous complications (renal failure, death, etc.) may be avoided.    

Article Details

How to Cite
Adama Seydou, S., I, K., I, K., M, D., SH, D., T, C., M, S., N, C., S, F., Y, M., & CO, G. (2020). Étude Épidémio-Clinique et Paraclinique des Rhabdomyolyses Non Traumatiques au Service de Neurologie du CHU Point G. HEALTH SCIENCES AND DISEASE, 21(12). https://doi.org/10.5281/hsd.v21i12.2387

References

  1. Ward M.M. Factors predictive of acute renal failure in rhabdomyolysis. Arch Intern Med 1988 ; 148 : 1553-7.
  2. Hue V, Martinot A. Fourier C, Cremer R et al. Rhabdomyolyses aiguës de l'enfantAcute rhabdomyolysis in childhood. Archives de Pédiatrie Volume 5, Issue 8, August 1998, Pages 887-95.
  3. McMahon GM, Zeng X, Waikar SS. A risk prediction score for kidney failure or mortality in rhabdomyolysis. JAMA Intern Med 2013;173:1821-8.
  4. El-Abdellati E, Eyselbergs M, Sirimsi H, Hoof W et al. An observational study on rhabdomyolysis in the intensive care unit. Exploring its risk factors and main complication: acute kidney injury. Ann Intensive Care 2013;3:8.
  5. Rodriguez E, Soler MJ, Rap O, Barrios C et al. Risk factors for acute kidney injury in severe rhabdomyolysis. PLoS One 013;8:e82992.
  6. Fournier JP, Oualid H, Martinez P et àl. Rhabdomyolyses non trauma tiques des heroinomanes : sept observations.Rean.Urg., 1992, 1 (2), 295-9.
  7. Jacob MC. Description rétrospective des rhabdomyolyses intenses de l’enfant. Thèse de faculté de médecine Paris Descartes 2013 N°49.
  8. Melli G, Chaudhry V, Cornblath DR. Rhabdomyolysis: an evaluation of 475 hospitalized patients. Medicine (Baltimore). nov 2005; 84(6):377‑85.
  9. Harrois A. Rhabdomyolyse et insuffisance rénale aigue. MAPAR 2017 : 393-408.
  10. Muthukrishnan J., Harikumar K., et al. Pregnancy predisposes to rhabdomyolysis due to hypokalemia. Saudi Journal of Kidney Diseases and transplantation, , 2010: vol. 21, n° 6, pp. 1127-8.
  11. Garminati G., Chena A., Orlando M., et al. Distal renal acidosis with rhabdomyolysis as the presenting form in 4 pregnant women. Nefrologia, 2001: vol. 21, n° 2, pp. 204-8.
  12. Visweswaran P, Guntupalli J. Rhabdomyolysis. Crit Care Clin 1999, 15:415-412. Critical Care 2005 Vol 9 No 2 : 167.
  13. Scolari Childress KM, Myles T. Baking soda pica associated with rhabdomyolysis and cardiomyopathy in pregnancy. Obstet Gynecol. 2013 Aug;122 (2 Pt 2):495-7.
  14. Madsen LR, Søgaard M, Rhabdomyolysis caused by hyperemesis gravidarum. UgeskrLaeger. 2017 Feb 27; (9) :179.
  15. Hardardottir H., Lahiri T., et Egan J.F. Renal tubular acidosis in pregnancy : case report and literature review. Journal of maternal-fetal Medecine,2001; vol. 6, n° 1, pp. 16-20.
  16. Rowe TF, Magee K, and Cunningham FG. “Pregnancy and renal tubular acidosis,” American Journal of Perinatology, 1999 : vol. 16, no. 4, pp. 189–91.
  17. Price JT, Schwartz N. Maternal rhabdomyolysis and twin fetal death associated with gestational diabetes insipidus. ObstetGynecol. 2013 Aug;122(2 Pt 2):493-5.
  18. Cervellin G, Comelli I, Lippi G. Rhabdomyolysis: historical background, clinical, diagnostic and therapeutic features. Clin Chem Lab Med. 2010 Jun;48(6):749-56.
  19. Tazarourte K, Foudi L, Foudi H, Gauthier A et al. Crush syndrome et rhabdomyolyse. Urgence 2011 sfmu-samu : 617-31.
  20. Brochard L, Abroug F, Brenner M, Broccard AF et al. An Official ATS/ERS/ESICM/SCCM/SRLF Statement: Prevention and Management of Acute Renal Failure in the ICU Patient: an international consensus conference in intensive care medicine. Am J Respir Crit Care Med 2010;181:1128-55.
  21. Kasaoka S, Todani M, Kaneko T, Kawamura Y et al. Peak value of blood myoglobin predicts acute renal failure induced by rhabdomyolysis. J Crit Care 2010;25:601-4.
  22. Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute kidney injury. N Engl J Med 2009;361:62-72.
  23. Hatamizadeh P, Najafi I, Vanholder R, Rashid-Farokhi F et al. Epidemiologic aspects of the Bam earthquake in Iran: the nephrologic perspective. Am J Kidney Dis 2006;47:428-38.
  24. Singh U and Michael Scheld W. Infectious Etiologies of Rhabdomyolysis: Three Case Reports and Review. Clinical Infectious Diseases 1996;22:642-9.
  25. Antons KA, Williams CD, Baker SK, Phillips PS. Clinical perspectives of statin-induced rhabdomyolysis. Am J Med. 2006 May;119(5):400-409.
  26. Cillis M, Hantson P. Rhabdomyolyse, statine et hyponatrémie Toxicologie Analytique et Clinique Volume 30, Issue 2, Supplement, June 2018 : 76-7.
  27. Becker CE. Medical complications of drug abuse. AdvIntern Med. 1979;24:183 – 202.
  28. Winslow BT, Voorhees KI, Pehl KA. Méthamphétamine abuse.Am Fam Physician. 2007 Oct 15;76(8):1169-74.
  29. Gabow P, Kaehny W, Kelleher S. The spectrum of rhabdomyolysis. Medicine 1982, 62:141-52.
  30. Tanaka T, Takada T, Takagi D, Takeyama N, et al. Acute renal failure due to rhabdomyolysis associated with echovirus 9 infection: a case report and review of literature. Jpn J Med 1989;28:237-42.
  31. Gherardi RK. Skeletal muscle involvement in HIV-infected patients. Neuropathol Appl Neurobiol 1994;20:232-7.
  32. Mahe A, Bruet A, Chabin E, Fendler JP. Acute rhabdomyolysis coincident with primary HIV-1 infection. Lancet 1989;2:1454-5.
  33. Falasca GF, Reginato AI. The spectrum of myositis and rhabdomyolysis associated with bacterial infection. J Rheumatol l994;21:1932-7.
  34. Martino R, Nomdedeu J, Sureda A, Mateu R, et al. Acute rhabdomyolysis complicating viridans streptococcal shock syndrome. Acta Haematol 1994; 92: 140-1.
  35. Shah A, Check F, Baskin S, Reyman T, Menard R. Legionnaires' disease and acute renal failure: case report and review. Clin Infect Dis 1992; 14:204-7.
  36. Wong KH, Moss CW, Hochstein DH, Arko RJ, et al. Woo"Endotoxicity" of legionnaires' disease bacterium. Ann Intern Med 1979; 90:624-7.
  37. Nicolas X, Granier H, Le Guen P, Talarmin F. Rhabdomyolyse aiguë associée à une primo-infection à VIH-1 : une nouvelle observation, La Revue de médecine interne 2007; (28): 322–5.
  38. Bedry R, Baudrimont I, Deffieux G et al. Wildmushroom intoxication as a cause of rhabdomyolysis. N Engl J Med 2001; 345:798-802.
  39. Boles JM, Garo B, Garre M. Rhabdomyolyses non traumatiques. Etude prospective de 100 cas en 3 ans. Réan Soins Intens Med Urg 1988;4:9-15.
  40. Bagley WH, Yang H, Shah KH. Rhabdomyolysis. Intern Emerg Med 2007 ; 2:210–8.
  41. Sharp LS, Rozycki GS, Feliciano DV. Rhabdomyolysis and secondary renal failure in critically ill surgical patients. Am J Surg 2004 ; 188: 801–6.
  42. Bellomo R., Daskalakis M., Parkin G., Boyce N. Myoglobin clearance during acute continuous hemodiafiltration. Intensive Care Med 1991 ; 17 (8) : 509.
  43. Splendiani G, Mazzarella V, Cipriani S, Zazzaro D et al. Dialytic treatment of rhabdomyolysis-induced acute renal failure: our experience. Ren Fail 2001, 23:183-91.
  44. Meijer AR, Fikkers BG, De Keijzer MH, Van Engelen BG et al. Serum creatine kinase as predictor of clinical course in rhabdomyolysis: a 5-year intensive care survey. Intensive Care Med 2003 ; 29: 1121–5.
  45. Woodrow G, Brownjohn AM, Turney JH. The clinical and biochemical features of acute renal failure due to rhabdomyolysis. Ren Fai 1995 ; 17: 467–74.

Most read articles by the same author(s)