Rhabdomyolysis and Aminotransferase Activity Due to Acute Intoxication With Psychotropic and Chemical Substances
Journal
Iranian Journal of Toxicology
Date Issued
2023-01
Author(s)
Abstract
Background: Rhabdomyolysis is caused by the release of enzymes from skeletal muscles into
the blood, which leads to systemic complications with diverse etiologies. This study evaluated
the serum aminotransferases in patients with rhabdomyolysis following acute intoxication with
either psychotropic drugs or other chemical agents.
Methods: This study randomly recruited 140 patients suffering from rhabdomyolysis. They
were divided into two groups affected by either psychotropic drugs or chemical agents.
Rhabdomyolysis was defined as having serum creatine kinase (CK) levels greater than 250
U/L, based on the poisoning severity score.
Results: On day 1, the CK/AST correlation was significantly stronger in the psychotropic
than the chemical group (P=0.0009). On day 5, patients in the psychotropic group had
significantly higher AST (P=0.0138) and ALT (P=0.0129) than those poisoned with other
chemicals. The difference in the strength of the CK/ALT correlation between the two groups
was insignificant. Between the two groups, the differences between the CK levels and the
following serum parameters were insignificant: Alkaline phosphatase; gamma-glutamyl
transferase; prothrombin time; total bilirubin; and albumin.
Conclusion: The elevated aminotransferases in patients with rhabdomyolysis due to acute
psychotropic toxicity might have resulted from the skeletal muscle injury rather than
hepatotoxicity. In rhabdomyolysis patients poisoned with other chemicals, the elevated serum
aminotransferases are likely due to liver toxicity arising from the consumed substances. These
patients are likely to manifest clinically severe long-term multi-organ failure. Intoxications
with typical agents, such as herbicides, petroleum distillates, and corrosives were responsible
for the rhabdomyolysis in the second group
the blood, which leads to systemic complications with diverse etiologies. This study evaluated
the serum aminotransferases in patients with rhabdomyolysis following acute intoxication with
either psychotropic drugs or other chemical agents.
Methods: This study randomly recruited 140 patients suffering from rhabdomyolysis. They
were divided into two groups affected by either psychotropic drugs or chemical agents.
Rhabdomyolysis was defined as having serum creatine kinase (CK) levels greater than 250
U/L, based on the poisoning severity score.
Results: On day 1, the CK/AST correlation was significantly stronger in the psychotropic
than the chemical group (P=0.0009). On day 5, patients in the psychotropic group had
significantly higher AST (P=0.0138) and ALT (P=0.0129) than those poisoned with other
chemicals. The difference in the strength of the CK/ALT correlation between the two groups
was insignificant. Between the two groups, the differences between the CK levels and the
following serum parameters were insignificant: Alkaline phosphatase; gamma-glutamyl
transferase; prothrombin time; total bilirubin; and albumin.
Conclusion: The elevated aminotransferases in patients with rhabdomyolysis due to acute
psychotropic toxicity might have resulted from the skeletal muscle injury rather than
hepatotoxicity. In rhabdomyolysis patients poisoned with other chemicals, the elevated serum
aminotransferases are likely due to liver toxicity arising from the consumed substances. These
patients are likely to manifest clinically severe long-term multi-organ failure. Intoxications
with typical agents, such as herbicides, petroleum distillates, and corrosives were responsible
for the rhabdomyolysis in the second group
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