From recurrent rhabdomyolysis in a young adult to carnitine palmitoyltransferase II deficiency

Cristina Marques, Catarina Silva, Carina Silva, Joao Pedro Abreu, Marcia Ribeiro, Arlindo Guimas

Abstract


Metabolic myopathies are a diverse group of rare genetic disorders associated with recurrent episodes of rhabdomyolysis, induced by triggers such as fever or exercise. In these disorders, the energetic metabolism is compromised resulting in damage of the muscle cells. The diagnosis can be challenging but is essential for the correct treatment. Carnitine palmitoytransferase II (CPT-II) deficiency is the most common long-chain fatty acid oxidation defect, with the adulthood form requiring additional external triggers. The authors present a case of a young-male adult with recurrent episodes of rhabdomyolysis, one of them presented with acute renal failure and acute hepatitis. The diagnostic is demanding, which requires a high level of suspicion. The adequate treatment of these patients improves the muscle function and prevents other episodes of severe rhabdomyolysis.

Keywords


rhabdomyolysis; acute renal failure; hepatitis; CPT II deficiency

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References


Krivickas LS. Recurrent rhabdomyolysis in a collegiate athlete: a case report. Med Sci Sports Exerc. 2006;38(3):407-410. doi: 10.1249/01.mss.0000187413.41416.7e. PMID: 16540825.

Uzel B, Altiparmak MR, Ataman R, Serdengeçti K. Acute renal failure due to carnitine palmitoyltransferase II deficiency. Neth J Med. 2003;61(12):417-420. PMID: 15025419.

Gjorgjievski N, Dzekova-Vidimliski P, Petronijevic Z, et al. Carnitine Palmitoyltransferase II Deficiency (CPT II) Followed By Rhabdomyolysis and Acute Kidney Injury. Open Access Maced J Med Sci. 2018;6(4):666-668. doi: 10.3889/oamjms.2018.158. PMID: 29731937; PMCID: PMC5927500.

Lilleker JB, Keh YS, Roncaroli F, Sharma R, Roberts M. Metabolic myopathies: a practical approach. Pract Neurol. 2018;18(1):14-26. doi: 10.1136/practneurol-2017-001708. PMID: 29223996.

Tarnopolsky MA. Metabolic Myopathies. Continuum (Minneap Minn). 2016;22(6, Muscle and Neuromuscular Junction Disorders):1829-1851. doi: 10.1212/CON.0000000000000403. PMID: 27922496.

Balasubramanian M, Jenkins TM, Kirk RJ, et al. Recurrent rhabdomyolysis caused by carnitine palmitoyltransferase II deficiency, common but under-recognised: Lessons to be learnt. Mol Genet Metab Rep. 2018;15:69-70. doi: 10.1016/j.ymgmr.2018.02.008. PMID: 29744303; PMCID: PMC5938603.

Lehmann D, Motlagh L, Robaa D, Zierz S. Muscle Carnitine Palmitoyltransferase II Deficiency: A Review of Enzymatic Controversy and Clinical Features. Int J Mol Sci. 2017;18(1):82. doi: 10.3390/ijms18010082. PMID: 28054946; PMCID: PMC5297716.

Sigauke E, Rakheja D, Kitson K, Bennett MJ. Carnitine palmitoyltransferase II deficiency: a clinical, biochemical, and molecular review. Lab Invest. 2003;83(11):1543-1554. doi: 10.1097/01.lab.0000098428.51765.83. PMID: 14615409.

Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis: pathogenesis, diagnosis, and treatment. Ochsner J. 2015;15(1):58-69. PMID: 25829882; PMCID: PMC4365849.

Stanley M, Chippa V, Aeddula NR, Quintanilla Rodriguez BS, Adigun R. Rhabdomyolysis. 2022. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–. PMID: 28846335.

Melek E, Bulut FD, Atmıs B, et al. An ignored cause of red urine in children: rhabdomyolysis due to carnitine palmitoyltransferase II (CPT-II) deficiency. J Pediatr Endocrinol Metab. 2017;30(2):237-239. doi: 10.1515/jpem-2016-0324. PMID: 28085674.




DOI: http://dx.doi.org/10.22551/2023.38.1001.10238

Copyright (c) 2023 Cristina Marques, Catarina Silva, Carina Silva, Joao Pedro Abreu, Marcia Ribeiro, Arlindo Guimas

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ISSN: 2360-6975