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Rhabdomyolysis frequent in EVD, may lead to kidney failure
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Researchers from France reported that rhabdomyolysis is more common in patients with Ebola virus disease than other viral infections.
Moreover, the disorder may lead to acute kidney injury in patients with Ebola virus disease (EVD) who do not survive.
In an observational study, the researchers evaluated 38 health care workers with confirmed or suspected EVD who presented to a French Military Ebola Virus Disease Treatment Center between January and April. Creatine kinase (CK) values from patients with confirmed EVD were compared with those of patients with unconfirmed EVD. Laboratory tests were conducted at admission and twice weekly. Among patients with confirmed EVD, characteristics were compared between survivors and nonsurvivors.
The researchers found that 81% of the EVD-confirmed patients had abnormal CK values ( > 380 U/L) on admission vs. 25% of nonconfirmed patients (P = .002). Similarly, rhabdomyolysis (CK > 1,000 U/L) was more common in EVD patients (59% in confirmed cases vs. 19% in nonconfirmed cases; P = .03). Thirty-six percent of confirmed EVD patients exhibited CK levels higher than 5,000 U/L.
The overall rate of fatality in EVD cases was 27.3%. EVD patients who did not survive had higher creatinine levels at admission (249 ± 160 μmol/L vs. 97 ± 30 μmol/L; P = .004) and throughout their hospitalization (522 ± 460 μmol/L vs. 119 ± 62 μmol/L; P = .001). Analyses of liver function showed significantly higher levels of bilirubin, alanine transaminase and INR in EVD patients who did not survive. Moreover, these patients had higher viral loads both at admission (P = .006) and during their hospital stay (P = .004) than those who survived.
“Our study shows that Ebola virus disease is associated with a muscle injury leading to rhabdomyolysis in most cases,” the researchers wrote. “This finding is uncommon for a viral infection. It may contribute to acute kidney injury and emphasizes the fact that fluid replacement is key in the therapy of Ebola patients.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.
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