A case of rhabdomyolysis in Sudan

Rhabdomyolysis is characterized by the breakdown of the sarcolemmal membrane and the discharge of intracellular materials into the bloodstream. This condition has high mortality rates. Therefore, this case report will be valuable in adding knowledge for preventing the severe aftereffects of rhabdomyolysis, such as AKI, heart failure, metabolic acidosis, and early hypocalcemia, as well as in promoting early diagnosis and treatment. We present a case of a Sudanese soldier with complicated rhabodomyolysis. A 40-year-old soldier, with a clear medical background apart from heavy smoking, presented to the emergency room (ER) with chest pain and right lower limb pain for one day. On further questioning, he had a history of dark urine and muscle cramps after heavy military exercise five days ago. In the ER after assessment, he was diagnosed with ST-elevation myocardial infarction (STEMI) and was out of the thrombolysis window. He also had right lower limb ischemia, confirmed by Doppler ultrasonography, in addition to an acute kidney injury. He was admitted to the intensive care unit (ICU), developed ischemic cardiomyopathy, and had a large left ventricular thrombus. His creatine kinase (CK) level was very high (52000 U/L), and his renal impairment was attributed to rhbdomyolysis. He received conservative treatment for ischemic cardiomyopathy and acute kidney injury (AKI) and underwent an embolectomy for his right lower limb ischemia. On the third day of ICU admission, he developed left lower limb ischemia, for which he underwent an embolectomy again. After 10 days of admission, his renal profile returned to normal with conservative treatment, and he is due to continue follow-up with the cardiology and surgical departments. Complicated rhabdomyolysis normally leads to acute kidney injury; therefore, rapid recognition and comprehensive management of the underlying causes can lead to favorable outcomes, including renal function recovery and reduced need for dialysis.