Reports Myoglobinemia

Hemoadsorption in Infection-Associated Rhabdomyolysis.

Suefke S, Sayk F, Nitschke M
TherApher Dial. 2016 Mar 17

This case study reports on a 55-year-old patient with history of arterial hypertension who was...

This case study reports on a 55-year-old patient with history of arterial hypertension who was admitted with complaints of dyspnea and symptoms of respiratory infection. In the further course the patient developed fulminant manifest pneumogenic sepsis and acute respiratory distress syndrome (ARDS) with massive requirements for fluids and catecholamines for hemodynamic stabilization. Plasma concentrations of myoglobin and creatine kinase increased drastically on top of his inflammatory response, indicative of massive infection-associated rhabdomyolysis. For treatment of his acute kidney injury grade III (crush kidney) and to lower inflammatory mediator and myoglobin levelsCytoSorb was installed in combination with renal replacement therapy. During the course of the treatment, plasma concentrations of IL-6, procalcitonin, myoglobin and creatine kinase decreased significantly. Levels of leucocytes, thrombocytes, alanine aminotransferase, and aspartate aminotransferase normalized over the 4 consecutive treatments. The clinical situation improved considerably including improvement of the patient’s respiratory situation and liver function. The patient was discharged at day 13 with ongoing renal failure and need for renal replacement therapy. In this patient, the application of CytoSorb resulted in a significant reduction of cytokines (i.e. IL-6) but also had an important additive effect on myglobin removal.

Cytosorb™ in a patient with legionella-pneumonia associated rhabdomyolysis

Wiegele M, Krenn CG.
ASAIO J. 2015 Jan 29

This case study reports on a 44-year-old man presenting with ongoing fever and impaired general...

This case study reports on a 44-year-old man presenting with ongoing fever and impaired general condition for more than 5 days. Respiratory insufficiency finally led to hospitalization and rapid admission to an ICU with intubation and ventilatory support. Chest x-ray and computed tomography confirmed the clinical diagnosis of ARDS. Investigation of patient’s specimen further revealed infection with Legionella pneumophila. Despite administration of antibiotics, liver enzymes and parameters of renal function deteriorated in parallel within the following days, indicating a trend toward multiple organ failure. Creatine kinase and myoglobin sera levels increased in combination with reduced urine excretion. Therefore Cytosorb™ treatment was started in stand-alone mode on day 6 after admission. Within 8 hours, myoglobin levels decreased from 18,390 to 10,020 ng/ml and in a second cycle again declined from 13,400 to 8,359 ng/ml. The patient’s condition improved subsequently. Renal function completely recovered and hemo-dialysis was not necessary at any time of hospitalization. No side effects of therapy have been observed. This is the first time that a decrease of myoglo-bin levels following application of Cytosorb™ could be demonstrated in vivo.