According to medical history, one day before being hospitalized, she performed 300 oil massages. After that, the child had severe pain in both legs but did not go for examination. The next day, she continued to play football and the pain increased sharply, unable to walk. The family took the child to the local hospital for emergency treatment and then transferred him to the City Children's Hospital.
Here, the patient was in a lethargic state, breathing fast 28 times/minute, pulse 120 times/minute, blood pressure 100/70 mmHg. Legs were poorly constricted and extended, thigh and calf muscles were painfully pressed, urine was dark. Test results showed sudden increase in liver enzymes, electrolyte disorders, metabolic acidosis...
According to BS.CKII Nguyen Minh Tien - Deputy Director of the City Children's Hospital, this is a typical manifestation of rhabdomyolysis syndrome, a condition in which the rhabdomyolysis muscle is acutely damaged, releasing a series of substances such as CK, myoglobin, potassium, and phosphate into the blood. Myoglobin, when elevated, can cause acute kidney damage and dangerous electrolyte disorders.
The patient was given active intravenous fluids (one and a half times the need), electrolyte adjustment, urine alkalization with bicarbonate and use of N-Acetyl Cysteine to support the liver. After 7 days of treatment, the condition improved significantly, liver enzymes and muscle enzymes gradually decreased, the child was awake and discharged from the hospital for outpatient monitoring.
BS.CKII Nguyen Minh Tien said that rhabdomyolysis in children is not as common as in adults but is easily overlooked. The causes may be viral infections, bacteria, overexertion, trauma, medication or metabolic disorders. Parents need to pay attention to signs such as muscle pain, muscle weakness, dark urine, especially after children exercise at high intensity.
Experts recommend that children should only exercise appropriately for their physical condition, avoid exertion lasting more than 30-45 minutes continuously to prevent dangerous complications to the liver, kidneys and other organs.
