Beneficial effects of dantrolene in the treatment of rhabdomyolysis as a potential late complication associated with COVID-19: a case report.
Beneficial effects of dantrolene in the treatment of rhabdomyolysis as a potential late complication associated with COVID-19: a case report.
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DOI：
10.1186/s40001-021-00489-8
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发表时间：
2021-02-08
影响因子：
4.2
通讯作者：
Kinoshita K
中科院分区：
文献类型：
--
作者：
Chiba N;Matsuzaki M;Mawatari T;Mizuochi M;Sakurai A;Kinoshita K
严重新冠肺炎的患者有呼吸、心血管、凝血、骨骼肌和中枢神经系统的紊乱。这些全身性衰竭可能与细胞因子释放综合征有关，其特征是高热、血小板减少、高铁血症和其他炎症标志物的升高。横纹肌溶解伴高烧是新冠肺炎罕见的并发症。新冠肺炎患者的这些临床症状之间的确切关系尚不清楚。我们报告一位36岁男性严重新冠肺炎合并横纹肌溶解及高烧的病例。入院后，他的病情继续恶化，体温很高。第9天，患者肌酸激酶和肌红蛋白水平升高，与横纹肌溶解相一致(分别为26046U/L和3668U/mL)。除了病毒治疗外，他还立即接受了水剂治疗。然而，患者持续发烧，肌酸激酶水平升高。该患者被诊断为新冠肺炎的晚期并发症，尽管他没有恶性高热或抗精神病药物恶性综合征的遗传易感性。丹曲林具有肌肉松弛和抗炎功能，显示出对横纹肌溶解、高热和升高血浆炎症标志物的潜在疗效。恶性高热不仅由麻醉剂引发，也由病毒感染引发。恶性高热的一个可能机制是肌浆网钙释放的过敏性。其中包括骨骼肌兰尼定受体钙释放通道的突变或激活。丹曲林是一种兰尼定受体拮抗剂，用作抗炎药。丹曲林对横纹肌溶解、炎症引起的体温升高和炎症标志物的增加显示出潜在的疗效。新冠肺炎中横纹肌溶解与高热相关的潜在机制可能与恶性高热的发病机制相似。
Patients with severe COVID-19 have disorders of the respiratory, cardiovascular, coagulation, skeletal muscle, and central nervous systems. These systemic failures may be associated with cytokine release syndrome, characterized by hyperpyrexia, thrombocytopenia, hyperferritinemia, and the elevation of other inflammatory markers. Rhabdomyolysis with high fever is a complication that is rarely found in COVID-19. The exact relations of these clinical conditions in patients with COVID-19 remain unknown. We present the case of a 36-year-old man with severe COVID-19 complicated by rhabdomyolysis and high fever. After admission, his condition continued to deteriorate, with a high body temperature. On day 9, the patient had elevated creatine kinase and myoglobin levels consistent with rhabdomyolysis (26,046 U/L and 3668 ng/mL, respectively). In addition to viral therapy, he was immediately treated with hydration. However, the patient had persistent fever and elevated creatine kinase levels. The patient was diagnosed with malignant hyperthermia as a late complication of COVID-19, although he had no hereditary predisposition to malignant hyperthermia or neuroleptic malignant syndrome. The administration of dantrolene with muscle relaxation and anti-inflammatory function showed potential efficacy for rhabdomyolysis, high fever, and increased plasma inflammatory markers. Malignant hyperthermia is triggered by not only anesthetic agents but also viral infections. A possible mechanism of malignant hyperthermia is hypersensitivity of calcium release from the sarcoplasmic reticulum. These include mutations in or the activation of the skeletal muscle ryanodine receptor calcium release channel. Dantrolene is a ryanodine receptor antagonist and is used as an anti-inflammatory agent. The administration of dantrolene showed potential efficacy for rhabdomyolysis, high body temperature due to inflammation, and increased inflammatory markers. The underlying mechanism of the association of rhabdomyolysis and high fever in COVID-19 might be similar to the pathogenesis of malignant hyperthermia.
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影响因子：
1.2
作者：
Suwanwongse, Kulachanya;Shabarek, Nehad
通讯作者：
Shabarek, Nehad
影响因子：
0.9
作者：
Valente-Acosta, Benjamin;Moreno-Sanchez, Francisco;Palomar-Lever, Andres
通讯作者：
Palomar-Lever, Andres
影响因子：
3
作者：
Voermans, N. C.;Snoeck, M.;Jungbluth, H.
通讯作者：
Jungbluth, H.
DOI：
10.26355/eurrev_202010_23247
发表时间：
2020-10
影响因子：
3.3
作者：
Jiang B;Liang S;Liang G;Wei H
通讯作者：
Wei H
DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
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作者：
Richardson, Safiya;Hirsch, Jamie S.;,
通讯作者：
,