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Master Thesis

Description rétrospective des rhabdomyolyses intenses de l'enfant

Abstract : Summary: The goals of our study were to describe the clinical presentation, the evolution and the etiologies of high-CPK rhabdomyolysis (CPK>6000 IU/L) in children and then to analyze the diagnostic approach carried out to establish its cause.
Patients and methods: We performed a retrospective study of patients under 18 who were hospitalized in our pediatric hospital and had CPK levels higher than 6000 IU/L.
Results: 119 files (75 males and 44 females) were found and studied. The median of the highest CPK was 13120 IU/L (range 6023-690760). 64 patients (54%) had been hospitalized in intensive care units, 31 (26%) in the neurometabolism department, 8 (7%) in the emergency room and 16 (13%) in other departments. They exhibited an alteration of clinical status (28%), myalgia (21%) or symptoms of viral infection (28%). 46% had respiratory symptoms and 50% hemodynamic failure; 12% were dialyzed and 20% died. For 50%, the cause of the rhabdomyolysis was already known on admission. In 25% the diagnostic has been established with certainty while the others 25% remained uncertain. The most common causes were visceral failures (28%), myopathies (20%), infections (15%), trauma (15%), surgery (14%), metabolic diseases (10%), LPIN1 mutations (3%). In 34%, different causes could explain the rhabdomyolysis. For 47% of the patients with uncertain diagnosis, the advised etiologic explorations had not been done.
As a conclusion, causes of rhabdomyolysis with CPK levels higher than 6000 IU/L are specific. These patients are more often hospitalized in intensive care units and have a higher mortality rate. They are also more likely to have a metabolic disease than patients with lower CPK rates.
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Submitted on : Friday, September 4, 2015 - 11:52:15 AM
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  • HAL Id : dumas-01193067, version 1


Claire Mehler Jacob. Description rétrospective des rhabdomyolyses intenses de l'enfant. Médecine humaine et pathologie. 2013. ⟨dumas-01193067⟩



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