PDF(Pubmed)
Abstract：
SummaryRhabdomyolysis is characterised by muscle breakdown which causes myoglobin light chain release and can result in renal injury. While some of the most common causes of rhabdomyolysis are trauma related, others include toxins, autoimmune processes or viral aetiologies. We present the case of a 20s-year-old man, with no significant medical history, who presented to the emergency department with a 1-week history of weakness, myalgias, nausea, vomiting and subjective fevers. A review of systems and physical exam were otherwise unremarkable, including being negative for sore throat, dysphagia and lymphadenopathy. On presentation, the patient was noted to have dark urine with a creatine kinase value of 452 458 U/L and an elevated creatinine at 7.23 mg/dL. The patient denied any trauma or increased physical activity. His toxin screen and autoimmune workup were negative. The patient\'s serological workup was significant for acute Epstein-Barr virus (EBV) infection, without additional viral coinfection or mononucleosis. During his hospitalisation course, the patient was managed with supportive care including haemodialysis. The patient made a full renal recovery and was discharged with scheduled outpatient follow-up. This case highlights the recognition of an acute EBV infection causing rhabdomyolysis in the absence of mononucleosis or concomitant infection.
摘要：
Summary横纹肌溶解症的特征在于引起肌红蛋白轻链释放并可导致肾损伤的肌肉分解。虽然横纹肌溶解症的一些最常见原因与创伤有关，其他包括毒素，自身免疫过程或病毒病因。我们介绍一个20岁的男人的案例，没有明显的病史，他带着一周的虚弱病史到急诊科就诊，肌痛,恶心,呕吐和主观发烧。对系统和身体检查的审查在其他方面并不引人注目，包括对喉咙痛呈阴性，吞咽困难和淋巴结肿大。在介绍时，患者出现深色尿液,肌酸激酶值为452458U/L,肌酐升高为7.23mg/dL.患者否认有任何创伤或体力活动增加。他的毒素筛查和自身免疫检查均为阴性。患者的血清学检查对急性EB病毒（EBV）感染具有重要意义，没有额外的病毒共感染或单核细胞增多症。在他住院期间，患者接受包括血液透析在内的支持性治疗.该患者的肾脏完全康复，并通过定期的门诊随访出院。该病例强调了在没有单核细胞增多症或伴随感染的情况下引起横纹肌溶解的急性EBV感染的识别。
