Exertional Rhabdomyolysis after Military Training Paralleled by Systemic Microvascular Dysfunction and Plasma Cytokine Increase: A Case Report

Introduction

Exertional rhabdomyolysis (ER) is diagnosed by the presence of intense muscular pain and sudden elevation of total plasma levels of the enzyme creatine kinase (CK), with or without myoglobinuria, is closely associated with acute fatigue during exercise, as well to the associated risk of acute renal injury, disseminated intravascular coagulation, cardiac arrhythmias, and electrolyte disturbances.

ER is highly prevalent in military training, particularly when performed in adverse climatic conditions, and many cases progress rapidly to acute, life-threatening renal failure. Moreover, it is estimated that about one-third of the cases of ER involve young male afro-descendants with low physical conditioning and extreme dehydration, occurring during summer military training courses. In those situations, clinically healthy young subjects are submitted to strenuous exercise routines performed with combat uniforms and equipment and without adequate hydration possibilities.

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