Heroin-associated rhabdomyolysis with cardiac involvement
L. Schwartzfarb, G. Singh and D. Marcus
A heroin addict had rhabdomyolysis with cardiac involvement. The patient
was admitted with edema of the right leg and oliguria. Admission diagnoses
were right illofemoral thrombophlebitis, acute renal failure, and heroin
addiction. Urinalysis was strongly positive for "blood" in the absence of
hemolysis or marked hematocyturia, and a diagnosis of rhabdomyolysis was
made. Peritoneal dialysis succeeded in lowering blood urea nitrogen and
serum potassium levels, but the patient died on the fourth hospital day.
Postmortem examination disclosed focal myocardial myolysis, diffuse
rhabdomyolysis of the right soleus muscle, and acute renal tubular
necrosis. Direct toxicity or hypersensitivity to heroin or an adulterant is
considered in the pathogenesis of myolysis.
