http://www.appliedradiology.com RSS Feed on Applied Radiologyhttp://www.appliedradiology.com//Issues/2012/01/Cases/Cocaine-induced-rhabdomyolysis-with-secondary-acute-renal-failure.aspx<p>A 50-year-old male patient with a history of prostate cancer treated with iodine-125 seed implants and previously documented degenerative lumbar spinal stenosis with chronic low back pain presented to the emergency room with severe low back and right flank pain. The patient denied any history of trauma or recreational drug use. The patient was treated with valium and pain medications; however, he experienced no improvement of symptoms. The patient also noted on the following day that his urine had darkened. The patient had earlier denied any history of abdominal pain, jaundice, rectal bleeding, or melena. On laboratory evaluation at the time of admission, the white cell count was 18000 per mcl (18000 µL), creatinine was 1.0 mg/dl and BUN 12 mg/dl. Upon subsequent testing, the patient’s creatine kinase (CK) level was greatly elevated to 21613 units/L (U/L). The patient’s erythrocyte sedimentation rate was also elevated and the urine returned positive for cocaine. The patient’s creatinine level rose over the following days to 4.7 mg/dl. As his back pain worsened, a magnetic resonance image (MRI) of the lumbar spine was obtained.</p> <p>A diagnosis of cocaine-induced rhabdomyolysis with secondary acute renal failure was made. With treatment, the patient’s creatine kinase levels decreased and pain improved over the following week. All fluid cultures were negative for infection. The patient was discharged after recovery of renal function and following appropriate counseling regarding recreational drug use. </p>Wednesday, 08 Feb 2012 11:36:21 GMT