Posterior reversible encephalopathy syndrome (PRES) is a rare condition manifested by inflammation in certain areas of the brain. Rhabdomyolysis with acute kidney injury (AKI) complicated by PRES is rarely reported. A 26-year-old female presented with neurological symptoms, high blood pressure, and AKI. Her symptoms improved with blood pressure control, anticonvulsant drug medications, and renal replacement therapy. This case demonstrates that PRES should be considered in the differential diagnosis of patients who have rhabdomyolysis with AKI accompanied by neurological symptoms, including headaches and convulsions.

Glycogen storage disease (GSD) type V, also known as McArdle’s disease, is an autosomal recessive genetic disease caused by a mutation of the PYGM gene related to the synthesis of the myophosphorylase enzyme. Here, we presented the case of an 83-year-old woman who was admitted for progressively worsening weakness of her legs due to rhabdomyolysis after a COVID-19 vaccination. In the muscle biopsy, myopathy with subsarcolemmal glycogen accumulation was revealed and she was diagnosed with a mild form of GSD type V. Although COVID-19 vaccines are generally safe and encouraged for everyone, adverse events following COVID-19 vaccinations are increasing. We should pay attention to the side effects of COVID-19 vaccination including rhabdomyolysis.

Citations

• COVID-19 Vaccine Side Effect Analysis by Leveraging Social Media: Focusing on Connectivity and Cluster Characteristics of Vaccine Side Effects
  Sunguk Yun, Jaekyun Jeong, Jungeun Kim
  IEEE Transactions on Computational Social Systems.2024; 11(5): 6487.     CrossRef

Background
Peripheral nerve injury rarely occurs in patients with rhabdomyolysis. Based on our experience and previous reports, we consider prolonged immobilization a risk factor for the development of peripheral neuropathy in rhabdomyolysis patients.
Methods
This study analyzed 28 patients with rhabdomyolysis due to prolonged immobilization. We analyzed their demographic and laboratory data, clinical and imaging findings, and outcomes, and compared these factors between patients with and without neuropathy.
Results
Seven of the 28 patients had peripheral neuropathy, including sciatic neuropathy or lumbosacral plexopathy. Compared to those without neuropathy, the patients with neuropathy were younger (p = 0.02), had higher peak creatine kinase (CK) levels (p = 0.02), had higher muscle uptake in bone scans (p = 0.03), and more frequently exhibited abnormal muscle findings in computed tomography (CT) (p = 0.004).
Conclusions
Patients with prolonged immobilization-induced rhabdomyolysis and neuropathy had higher CK levels, increased uptake on bone scans, and more-frequent abnormal muscles on CT than those without neuropathy. These findings indicate that peripheral neuropathy is more likely to develop in patients with severe muscle injury.

Citations

• Crushing Muscles: A Case Study on Rhabdomyolysis, Renal Failure, and Compartment Syndrome Triggered by Pre-Workout Supplement Abuse
  Faryal Altaf, Vedangkumar Bhatt, Sindhaghatta Venkatram, Gilda Diaz-fuentes
  Cureus.2024;[Epub]     CrossRef
• Foot drop secondary to rhabdomyolysis: improved foot dorsiflexion and gait after neurolysis and distal nerve transfer—a case series and literature review
  Rahul K Nath, Chandra Somasundaram
  Journal of Surgical Case Reports.2023;[Epub]     CrossRef
• A Rare Complication of Rhabdomyolysis: Peripheral Neuropathy
  Chidinma Ejikeme, Ramez Alyacoub, Sherif Elkattawy, Tanya Shankar, Ruhin Yuridullah
  Cureus.2021;[Epub]     CrossRef

Primary aldosteronism is one of the most common cause of secondary hypertension and can be accompanied with hypokalemia. Rhabdomyolysis with hypokalemia in primary aldosteronism has been rarely reported. We describe a patient of primary aldosteronism who presented with limb-girdle type weakness.