A junior high school girl competed with classmates in frog jumps at school, then went hiking the next day during the holiday. After two consecutive days of intense exercise without adequate hydration, she experienced such severe leg pain that she struggled to get in and out of bed. Medical examination revealed she had developed rhabdomyolysis. After being promptly transferred to the ICU for medication and hydration, she recovered and was discharged from the hospital after two days.
A 14-year-old girl, Xiao Hong (pseudonym), sought treatment at the Shiren Clinic in Changhua City. She told Dr. Liu Zi-yin that she had done frog jumps in the classroom—about a dozen rounds—and although her legs were sore, she still went hiking early the next morning. By the time she got home, her legs were extremely stiff, making it difficult to squat on the toilet, so she avoided drinking water. The next day, she developed hematuria, with her urine turning a dark tea color, which frightened her into seeking urgent medical help.
A 14-year-old female junior high school student, Xiao Hong (pseudonym), from Changhua City, played frog jumps with classmates and went hiking the next day, resulting in “iron legs” and such severe leg soreness that she couldn’t squat on the toilet or drink much water. Unexpectedly, she developed hematuria, with her urine even turning a dark cola color. Medical examination revealed rhabdomyolysis. She was transferred from the clinic to the ICU at Changhua Christian Hospital for treatment and has since recovered and been discharged.
Dr. Liu Zi-yin stated that the patient’s urine test showed occult blood (i.e., hematuria) but no infection. Further tests ruled out the possibility of urinary tract stones. Observing that Xiao Hong had great difficulty getting in and out of bed and walking, and learning that her leg muscles were extremely sore and she could barely squat on the toilet, the doctor realized she was avoiding water intake. Suspecting “rhabdomyolysis,” they immediately drew blood for testing and provided medication and large amounts of hydration. Concerned about the possibility of acute kidney failure, she was promptly referred to Changhua Christian Hospital’s pediatric department for treatment.
Dr. Chen Liang-ren, director of the Emergency Department at Changhua Christian Hospital’s Pediatric Division, pointed out that when Xiao Hong first visited the Shiren Clinic in Changhua City, tests showed that her creatine phosphokinase (CPK) levels in the blood had soared to tens of thousands (normal values are in the dozens to hundreds U/L), confirming a diagnosis of rhabdomyolysis. In addition to administering intravenous fluids to increase body hydration and diuretics to promote urination, she was transferred to the ICU for two days, which helped prevent the onset of acute kidney failure. By the time of discharge, her kidney function had returned to normal.
Dr. Chen Liang-ren reminded that rhabdomyolysis occurs when muscle tissue is injured, causing muscle cells to die and release large amounts of myoglobin into the bloodstream in a short time. If not promptly expelled, it can damage kidney function and lead to acute kidney failure, possibly requiring dialysis. Common symptoms of rhabdomyolysis manifest as muscle soreness, with the degree of soreness varying from person to person. If you notice muscle soreness along with unusually dark urine, similar to the color of black tea or cola, and a significant decrease in urine output, you should be alert and seek medical attention immediately.
(China Times)