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Beneficial effects of dantrolene in the treatment of rhabdomyolysis as a potential late complication associated with COVID-19: a case report
- Source :
- European Journal of Medical Research, European Journal of Medical Research, Vol 26, Iss 1, Pp 1-4 (2021)
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Background Patients with severe COVID-19 have disorders of the respiratory, cardiovascular, coagulation, skeletal muscle, and central nervous systems. These systemic failures may be associated with cytokine release syndrome, characterized by hyperpyrexia, thrombocytopenia, hyperferritinemia, and the elevation of other inflammatory markers. Rhabdomyolysis with high fever is a complication that is rarely found in COVID-19. The exact relations of these clinical conditions in patients with COVID-19 remain unknown. Case presentation We present the case of a 36-year-old man with severe COVID-19 complicated by rhabdomyolysis and high fever. After admission, his condition continued to deteriorate, with a high body temperature. On day 9, the patient had elevated creatine kinase and myoglobin levels consistent with rhabdomyolysis (26,046 U/L and 3668 ng/mL, respectively). In addition to viral therapy, he was immediately treated with hydration. However, the patient had persistent fever and elevated creatine kinase levels. The patient was diagnosed with malignant hyperthermia as a late complication of COVID-19, although he had no hereditary predisposition to malignant hyperthermia or neuroleptic malignant syndrome. The administration of dantrolene with muscle relaxation and anti-inflammatory function showed potential efficacy for rhabdomyolysis, high fever, and increased plasma inflammatory markers. Conclusions Malignant hyperthermia is triggered by not only anesthetic agents but also viral infections. A possible mechanism of malignant hyperthermia is hypersensitivity of calcium release from the sarcoplasmic reticulum. These include mutations in or the activation of the skeletal muscle ryanodine receptor calcium release channel. Dantrolene is a ryanodine receptor antagonist and is used as an anti-inflammatory agent. The administration of dantrolene showed potential efficacy for rhabdomyolysis, high body temperature due to inflammation, and increased inflammatory markers. The underlying mechanism of the association of rhabdomyolysis and high fever in COVID-19 might be similar to the pathogenesis of malignant hyperthermia.
- Subjects :
- Adult
Male
medicine.medical_specialty
lcsh:Medicine
Case Report
Gastroenterology
Rhabdomyolysis
Dantrolene
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Immune response
Hyperpyrexia
biology
Muscle Relaxants, Central
SARS-CoV-2
Ryanodine receptor
business.industry
lcsh:R
Malignant hyperthermia
COVID-19
General Medicine
medicine.disease
Neuroleptic malignant syndrome
Cytokine release syndrome
Muscle relaxation
030220 oncology & carcinogenesis
biology.protein
Creatine kinase
Malignant Hyperthermia
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 2047783X
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- European Journal of Medical Research
- Accession number :
- edsair.doi.dedup.....61dafa12106c65062ea748b51c3ddfd0
- Full Text :
- https://doi.org/10.1186/s40001-021-00489-8