A case report on the acute and late complications associated with carbon monoxide poisoning: Acute kidney injury, rhabdomyolysis, and delayed leukoencephalopathy

Medicine (Baltimore). 2019 May;98(19):e15551. doi: 10.1097/MD.0000000000015551.

Abstract

Rationale: Acute kidney injury (AKI), rhabdomyolysis, and delayed leukoencephalopathy after carbon monoxide (CO) poisoning are very rare. We report a case presenting with AKI, rhabdomyolysis, and delayed leukoencephalopathy after CO poisoning.

Patient concerns: The patient was admitted to our emergency department due to loss of consciousness after CO exposure during a suicide attempt.

Diagnoses: Laboratory findings revealed elevated carboxyhemoglobin, serum creatinine, and serum muscle enzyme levels. Initially, this patient was diagnosed with AKI and rhabdomyolysis due to CO poisoning. A month after the CO poisoning, she showed neuropsychiatric symptoms. Brain magnetic resonance imaging showed white-matter hyperintensity on the T2 flair image. Therefore, she was diagnosed with delayed leukoencephalopathy after CO poisoning.

Interventions: At the same time as diagnosis of AKI and rhabdomyolysis, the normobaric oxygen and hydration therapies were performed. A month later, rehabilitation was started due to delayed leukoencephalopathy.

Outcomes: Her renal function and muscle enzyme levels were completely restored with alert mental status. She could walk with the aid of a walker at last visit.

Lessons: This case shows that we should consider about rare acute and late complications such as AKI, rhabdomyolysis, and delayed leukoencephalopathy after CO poisoning.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / physiopathology
  • Acute Kidney Injury / therapy
  • Adult
  • Brain / diagnostic imaging
  • Carbon Monoxide Poisoning / complications*
  • Carbon Monoxide Poisoning / diagnostic imaging
  • Carbon Monoxide Poisoning / physiopathology
  • Carbon Monoxide Poisoning / therapy
  • Female
  • Humans
  • Leukoencephalopathies / diagnostic imaging
  • Leukoencephalopathies / etiology*
  • Leukoencephalopathies / physiopathology
  • Leukoencephalopathies / therapy
  • Rhabdomyolysis / etiology*
  • Rhabdomyolysis / physiopathology
  • Rhabdomyolysis / therapy
  • Suicide, Attempted