Rhabdomyolysis without detectable myoglobulinuria due to severe hypophosphatemia in diabetic ketoacidosis

Pediatr Emerg Care. 2011 Jun;27(6):537-8. doi: 10.1097/PEC.0b013e31821dc68a.

Abstract

Clinical signs of hypophosphatemia, even when severe, are rare in diabetic ketoacidosis despite their high frequency in this condition. This article presents a patient with rhabdomyolysis due to severe hypophosphatemia, where the level of serum phosphorus was observed to be as low as 0.42 mg/dL on the 16th hour of ketoacidosis treatment. The patient developed acute tubular necrosis due to rhabdomyolysis, but there was no blood reaction in the urine, and the creatine kinase increased to 1200 U/L. The patient was treated without dialysis and was cured after a polyuria period of 2 months after the oliguric period.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / therapy
  • Child
  • Creatine Kinase / blood
  • Diabetic Ketoacidosis / blood
  • Diabetic Ketoacidosis / complications*
  • Diabetic Ketoacidosis / diagnosis
  • Diagnosis, Differential
  • Follow-Up Studies
  • Humans
  • Hypophosphatemia / blood
  • Hypophosphatemia / complications*
  • Hypophosphatemia / therapy
  • Male
  • Myoglobinuria
  • Phosphates / blood*
  • Renal Dialysis
  • Rhabdomyolysis / blood
  • Rhabdomyolysis / diagnosis
  • Rhabdomyolysis / etiology*
  • Severity of Illness Index

Substances

  • Phosphates
  • Creatine Kinase