Clinical features and progress of pediatric acute rhabdomyolysis

Rhabdomyolysis is a clinical picture which is rarely seen in children. Pediatric rhabdomyolysis is a diagnosis that pediatricians need to be able to recognize because prompt treatment can prevent potential complications, such as acute kidney injury. It can result from a wide variety of disorders, such as trauma, infection, exercise, prolonged seizure and medications, but in the pediatric population, infection and inherited disorders are the most common causes of rhabdomyolysis. The pathophysiology behind rhabdomyolysis is complex and still being researched, but having a firm understanding of the cascade that results when muscle injury occurs is essential for proper management. Early recognition is important to prevent acute renal failure (ARF) through the use of sufficient hydration. The cause of acute pediatric rhabdomyolysis is different from that of adult rhabdomyolysis. The risk of acute renal failure in children is much less than the risk reported for adults. We performed a retrospective chart review to identify patients with creatinine kinase levels of 1000 IU/L who were treated in the pediatric intensive care unit between january 2016 and august 2021. Two thousand eighty patients were studied. Two hundred twenty one patients met study eligibility (141 male and 80 female), with a median age of 6,5 years. The most common causes of pediatric rhabdomyolysis were infection (31,2) and trauma (36,2) in our study. AKI developed in 24.4% of the patients. 37.6% of them had accompanying chronic diseases, epilepsy (n: 35) and cerebral palsy (n: 32) were the most common diseases in these patients. 29.1% of the patients ended up ex, 70.9% of them were discharged. Novel studies on pediatric rhabdomyolysis are limited, and in our study, ARF rates were found to be lower in children compared to adults. When the literature was reviewed, unlike previous studies, the use of chloralhydrate in rhabdomyolysis due to dystonia, the first pediatric case of COVID-19 followed up with rhabdomyolysis, was evaluated. Guidelines for managing pediatric rhabdomyolysis currently do not exist, but our study aims to give clinicians a general approach to aid in history taking, physical examination, diagnosis, acute management, follow-up, and prevention. Key words: pediatric, rhabdomyolysis, creatine, kinase. renal failure