Nontraumatic rhabdomyolysis in hyperosmolar nonketotic diabetic coma: A case report

G. Famularo, M. Perino, S. Polchi, M. Giacanelli, A. Taddeo, A. Nobili, C. Paolini, A. Panegrossi

Research output: Contribution to journalArticle

Abstract

Rhabdomyolysis greatly increases the risk of death in subjects with diabetic emergencies but only a few cases have been so far reported. We describe a patient with hyperosmolar nonketotic diabetic coma whose course was complicated by rhabdomyolysis progressing to acute renal failure. The course was severe but renal function was recovered to normal. Major determinants for the occurrence of rhabdomyolysis in diabetic subjects are hyperosmolarity and elevated blood levels of sodium and glucose. Hyperosmolar nonketotic diabetic coma is strongly predictive for acute renal failure and risk of death in subjects admitted because of diabetic emergencies; advanced age, previous dehydration and hyperuricemia are additional predictive factors. Clinical expression of rhabdomyolysis is small in diabetic patients as they rarely experience muscle discomfort and so the finding of elevated serum concentrations of creatinkinase (> 1000 IU/l) in the absence of acute myocardial infarction, stroke and end-stage renal disease is crucial to the early diagnosis of rhabdomyolysis. Even though no specific treatment for rhabdomyolysis is available, prompt resuscitation with fluid load has the potential to prevent the development of acute renal failure. Other strategies with claimed benefit, such as dantrolene, intravenous mannitol and urine alkalinization by administration of sodium bicarbonate, require further investigation.

Original languageEnglish
Pages (from-to)113-116
Number of pages4
JournalEuropean Journal of Internal Medicine
Volume9
Issue number2
Publication statusPublished - 1998

Keywords

  • Hyperosmolar nonketotic diabetic coma
  • Myoglobinuria
  • Rhabdomyolysis

ASJC Scopus subject areas

  • Medicine(all)
  • Internal Medicine

Fingerprint Dive into the research topics of 'Nontraumatic rhabdomyolysis in hyperosmolar nonketotic diabetic coma: A case report'. Together they form a unique fingerprint.

  • Cite this

    Famularo, G., Perino, M., Polchi, S., Giacanelli, M., Taddeo, A., Nobili, A., Paolini, C., & Panegrossi, A. (1998). Nontraumatic rhabdomyolysis in hyperosmolar nonketotic diabetic coma: A case report. European Journal of Internal Medicine, 9(2), 113-116.