Tetanus as a cause of acute renal failure: possible role of rhabdomyolysis

To study the frequency and examine the role of rhabdomyolysis in the acute renalfailure in tetanus 18 patients with the diagnosis of generalized tetanus consecutively admitted to the infectious disease hospital were evaluated. Ofthese 14 were male and 4female with mean age of 31.8± 2.0 years. Except...

Full description

Bibliographic Details
Main Authors: Reinaldo Martinelli, Cácia M. Matos, Heonir Rocha
Format: Article in Journal/Newspaper
Language:English
Published: Sociedade Brasileira de Medicina Tropical (SBMT) 1993
Subjects:
Online Access:https://doaj.org/article/894749907b9b40da8d9252f6678819a4
Description
Summary:To study the frequency and examine the role of rhabdomyolysis in the acute renalfailure in tetanus 18 patients with the diagnosis of generalized tetanus consecutively admitted to the infectious disease hospital were evaluated. Ofthese 14 were male and 4female with mean age of 31.8± 2.0 years. Except for mild proteinuria recorded in 9 patients, the urinalysis were unremarkable. Serum creatinine higher than 1.4mg/dl was recorded in 39% of the patients, abnormal levels of CPK in 87,5% and serum myoglobin greater than 120µg/l in 39% of the patients. Oliguria was documented in one patient and none required diafysis therapy. No correlation wasfound between renal failure and myoglobin and/or CPK serum levels. Acute renalfailure in tetanus was not infrequent; usualfy it was non-oliguric, mild and transient and not related to the severity of the disease or to serum levels of myoglobin and/or CPK. Com o objetivo de estudar a freqüência de insuficiêncai renal aguda e o papel da rabdomiólise na sua patogênese, 18 pacientes adultos com o diagnóstico de tétano, consecutivamente admitidos no hospital de doenças infecciosas (Hospital Couto Maia, Salvador, BA)foramprospectivamente avaliados. Destes, 14 eram do sexo masculino e 4 do feminino, com idade média de 31,8± 2,0 anos. Exceto porproteinúria leve a moderada (< 100mg/dl) em 9pacientes, os sumários de urina foram considerados normais. Creatininas séricas superiores a l,4mg/dl foram observadas em 39% dos pacientes, níveis elevados de CPK em 87,5% e mioglobina sérica maior que 120µg/dl em 39%. Oligúria foi documentada em apenas um paciente; nenhum paciente requereu tratamento dialítico. Não foram observadas correlações entre insuficiência renal aguda e níveis séricos de mioglobina e/ou CPK. A insuficiência renal aguda no tétano não foi infreqüente; geralmente é não-oligúrica, de pequena gravidade, transitória e não relacionada à severidade da doença ou aos níveis séricos de mioglobina e/ou CPK.