A 17-year-old girl presented to the emergency department with bilateral triceps pain, swelling, and stiffness after participating in 2 days of summer cheerleading camp in August 2015. Serum creatine kinase (CK) was measured at 32 531 IU/L. The patient was diagnosed with exertional rhabdomyolysis (ER). A full chemistry panel (serum electrolytes, serum urea nitrogen/creatinine, glucose, calcium, magnesium, phosphate), serum CK, and urinalysis with microscopy was obtained. The patient received 2 L normal saline (NS) by intravenous (IV) bolus in the emergency department and was admitted to the inpatient ward. As she was one of several patients subsequently admitted from her cheerleading training camp, the pediatric hospitalist and nephrology services created a standardized inpatient management protocol according to which all admitted patients were treated (Table 1). This protocol delineated admission criteria, approach to inpatient management with contingency planning, and discharge criteria. It is based on current adult and pediatric...
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December 2016
Illustrative Case|
December 01 2016
A Case of Exertional Rhabdomyolysis: A Cheer for Standardizing Inpatient Management and Prevention
Youyang Yang, MD;
aDepartment of Pediatrics, and
Address correspondence to Youyang Yang, MD, Department of Pediatrics, Massachusetts General Hospital, 175 Cambridge St, 5th Floor, Boston, MA 02114. E-mail: yyang12@partners.org
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Lindsay P. Carter, MD;
Lindsay P. Carter, MD
aDepartment of Pediatrics, and
bDivisions of Pediatric Hospital Medicine,
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Rebecca E. Cook, MD, MSc;
Rebecca E. Cook, MD, MSc
aDepartment of Pediatrics, and
bDivisions of Pediatric Hospital Medicine,
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Elahna Paul, MD;
Elahna Paul, MD
aDepartment of Pediatrics, and
cPediatric Nephrology, and
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Kevin R. Schwartz, MD
Kevin R. Schwartz, MD
aDepartment of Pediatrics, and
bDivisions of Pediatric Hospital Medicine,
dPediatric Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Address correspondence to Youyang Yang, MD, Department of Pediatrics, Massachusetts General Hospital, 175 Cambridge St, 5th Floor, Boston, MA 02114. E-mail: yyang12@partners.org
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Hosp Pediatr (2016) 6 (12): 753–756.
Citation
Youyang Yang, Lindsay P. Carter, Rebecca E. Cook, Elahna Paul, Kevin R. Schwartz; A Case of Exertional Rhabdomyolysis: A Cheer for Standardizing Inpatient Management and Prevention. Hosp Pediatr December 2016; 6 (12): 753–756. https://doi.org/10.1542/hpeds.2016-0082
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