Rhabdomyolysis is the destruction of skeletal muscle tissue with release of intracellular components into the circulation. Elevation of creatine kinase levels in serum is indicative of muscle damage and is associated with acute kidney injury. Antihistamines are a rare cause of nontraumatic rhabdomyolysis. Herein we describe a case of intentional ingestion of diphenhydramine resulting in rhabdomyolysis with subsequent elevation in creatine kinase levels exceeding 2 million IU/L. Aggressive intravenous volume expansion rapidly lowered creatine kinase levels and improved renal function.
Keywords: Creatine kinase; diphenhydramine toxicity; rhabdomyolysis.
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Rhabdomyolysis and acute renal failure following an ethanol and diphenhydramine overdose.Ann Pharmacother. 2003 Apr;37(4):538-42. doi: 10.1345/aph.1C241. Ann Pharmacother. 2003. PMID: 12659612
[Acute rhabdomyolysis: a case report and literature review].Acta Med Croatica. 2008 Jul;62(3):317-22. Acta Med Croatica. 2008. PMID: 18843854 Croatian.
Incidence of increased creatine kinase and its effect on kidney function in hand assisted laparoscopic kidney donors and their recipients.J Urol. 2007 Oct;178(4 Pt 1):1391-5; discussion 1395. doi: 10.1016/j.juro.2007.05.130. Epub 2007 Aug 16. J Urol. 2007. PMID: 17707064
[Rhabdomyolysis after radical nephrectomy in the lateral decubitus position: report of 2 cases].Nihon Hinyokika Gakkai Zasshi. 2014 Oct;105(4):218-23. doi: 10.5980/jpnjurol.105.218. Nihon Hinyokika Gakkai Zasshi. 2014. PMID: 25757354 Review. Japanese.
Coincidence of Nicolau Syndrome and Rhabdomyolysis: Report of a Forensic Autopsy Case and Review of the Literature.J Forensic Sci. 2016 Sep;61(5):1369-74. doi: 10.1111/1556-4029.13126. Epub 2016 Jun 20. J Forensic Sci. 2016. PMID: 27320825 Review.