On 12/2, Doctor Nguyen Minh Tien, Deputy Director of Children's Hospital City, stated that the patient was admitted in a lethargic state with a rapid heart rate of 120 beats per minute. He presented with weak leg movement and severe pain upon palpation of his thigh and calf muscles. Notably, his urine was dark red-brown.
According to his medical history, the patient complained of leg pain after performing approximately 300 squats (an exercise involving standing up and sitting down, impacting the thighs, glutes, and hips). However, he neglected to seek medical attention. The following day, he continued to play football, which intensified the pain to the point of immobility. His family then took him to a local hospital for first aid before transferring him to a higher-level facility.
Test results revealed severe damage. The patient exhibited metabolic acidosis, and his liver enzymes surged above 2,000 U/L. Significantly, his CPK muscle enzyme index increased to 215,240 U/L, a level more than 1,000 times higher than the normal range of 30-200 U/L. Myoglobin levels in his blood and urine were also thousands of times higher than the permissible limit. Doctors diagnosed him with rhabdomyolysis due to strenuous exercise.
According to Doctor Tien, Myoglobin is a protein that stores and supplies oxygen to muscles. When muscles are severely damaged, Myoglobin is massively released into the bloodstream, causing renal tubular obstruction. This can lead to acute kidney failure and makes the urine appear coca-cola or sarsaparilla colored.
The patient received fluids at one and a half times the normal requirement, urine alkalinization medication, electrolyte adjustment, and liver detoxification support. After 7 days of intensive treatment, his liver and muscle enzymes gradually decreased. The patient became alert, was able to walk, and was discharged.
Doctor Tien noted that rhabdomyolysis is less common in children than adults but is often overlooked. Potential causes include: infection, trauma, or excessive exercise, such as high-intensity sports or physical punishment. Parents should watch for the "classic triad" to ensure timely emergency care: muscle pain, muscle weakness (inability to walk, limp limbs), and dark urine (red-brown, coca-cola, or sarsaparilla colored).
To prevent this condition, doctors advise children to engage in exercise and physical activity appropriate for their health. It is crucial to avoid overly intense or prolonged continuous exercises (over 30-45 minutes) when the body is not yet adapted, to prevent the risk of muscle breakdown, kidney failure, and other dangerous complications.
Le Phuong
