Severe Elevation in Serum Creatinine Kinase in a Patient with Rhabdomyolysis Following Intensive Exercise: A Case Report

Abstract

Background: Rhabdomyolysis is a clinical and biochemical syndrome characterized by the release of cellular contents into circulation due to skeletal muscle injury. Important indicators of muscle damage include myoglobin, creatinine kinase (CK), and lactate dehydrogenase. The severity of the condition can vary from asymptomatic increases in muscle enzymes to life-threatening electrolyte disturbances and renal failure. Electrolytes released into circulation along with myoglobin secondary to myocyte membrane damage are responsible for the development of complications. Acute kidney injury can occur, especially when myoglobin accumulation in renal tubules is accompanied by hypovolemia and renal vasoconstriction. This case presentation aims to discuss an exercise-related rhabdomyolysis case with a CK level of 71150 IU/L, in conjunction with current literature. Case Presentation: A 32-year-old male patient presented to the emergency department with complaints of weakness and severe pain in both legs after intense exercise. His work up revealed a CK level of 71150 IU/L, alanine aminotransferase (ALT) 92 IU/L, aspartate aminotransferase (AST) 691 IU/L, and potassium (K) 5.7 mEq/L. He is diagnosed with acute rhabdomyolysis due to exercise and intravenous fluids administered. He didn’t require hemodialysis. On 17^th day of admission, he is discharged with full recovery. Conclusions: Physicians should be aware of rhabdomyolysis in patients presenting with weakness and muscle pain, especially in those reporting intensive physical exercise.