A 23-year-old Healthy Male with Syncope after Playing Futsal: A Case of Exertional Rhabdomyolysis

Case Report

Authors

  • David Kristianus Husada Hospital, Jakarta, Indonesia
  • Jonkie Budi Tirtadjaja Husada Hospital, Jakarta, Indonesia

DOI:

https://doi.org/10.55175/cdk.v52i7.1508

Keywords:

Exertional rhabdomyolysis, futsal, syncope

Abstract

Introduction: Exertional rhabdomyolysis (ER) is a medical condition resulting from strenuous exercise characterized by skeletal muscle damage followed by the release of intracellular components into the circulation. ER has various clinical manifestations and is associated with various complications that increase morbidity and mortality. Case: A 23-year-old male came to the emergency department with decreased consciousness after playing futsal. After urinary catheter insertion, brown-colored urine was observed. Laboratory examination showed increased serum CK level (199,011 IU/L), increased serum creatinine, hyperkalemia, and metabolic acidosis. The diagnosis was exertional rhabdomyolysis, acute kidney injury, hyperkalemia, and metabolic acidosis. Conclusion: The condition of the patient improved after aggressive intravenous rehydration, intravenous insulin, and sodium bicarbonate therapy. Prompt diagnosis and appropriate management can reduce complications, morbidity and mortality.

Downloads

Download data is not yet available.

References

Peng F, Lin X, Sun LZ, Zhou W, Chen Y, Li P, et al. Exertional rhabdomyolysis in a 21-year-old healthy man resulting from lower extremity training: A case report. Medicine (Baltimore). 2019;98(28):e16244. DOI: 10.1097/MD.0000000000016244.

Kodadek L, Carmichael Ii SP, Seshadri A, Pathak A, Hoth J, Appelbaum R, et al. Rhabdomyolysis: An American Association for the Surgery of Trauma Critical Care Committee clinical consensus document. Trauma Surg Acute Care Open. 2022;7(1):e000836. DOI: 10.1136/tsaco-2021-000836.

Carneiro A, Viana-Gomes D, Macedo-da-Silva J, Lima GHO, Mitri S, Alves SR, et al. Risk factors and future directions for preventing and diagnosing exertional rhabdomyolysis. Neuromuscul Disord. 2021;31(7):583-95. DOI: 10.1016/j.nmd.2021.04.007.

Tibana RA, Sousa NMF, Cunha GV, Prestes J, Navalta JW, Voltarelli FA. Exertional rhabdomyolysis after an extreme conditioning competition: A case report. Sports (Basel). 2018;6(2):40. DOI: 10.3390/sports6020040.

Kim J, Lee J, Kim S, Ryu HY, Cha KS, Sung DJ. Exercise-induced rhabdomyolysis mechanisms and prevention: A literature review. J Sport Health Sci. 2016;5(3):324-33. DOI: 10.1016/j.jshs.2015.01.012.

Gupta A, Thorson P, Penmatsa KR, Gupta P. Rhabdomyolysis: Revisited. Ulster Med J. 2021;90(2):61-9. PMID: 34276082.

Al Badi A, Al Rasbi S, Alalawi AM. Exercise-induced rhabdomyolysis: A case report and literature review. Cureus. 2020;12(8):e10037. DOI: 10.7759/cureus.10037.

Alharbi KF, Alfahmi MZ. Exercise-induced rhabdomyolysis manifestations and complications: A case report. Ann Med Surg (Lond). 2023;85(12):6285-8. DOI: 10.1097/MS9.0000000000001479.

Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis: Pathogenesis, diagnosis, and treatment. Ochsner J. 2015;15(1):58-69. PMID: 25829882.

Carenzo L, Ghio FE, Mariani N, Adami PE, Cecconi M, Bonizzato S. An unusual case of marathon-related exercise associated collapse: Case report and some considerations for medical care at endurance mass participation events. J Sci Med Sport. 2024;27(1):20-4. DOI: 10.1016/j.jsams.2023.10.010.

Garcia CK, Renteria LI, Leite-Santos G, Leon LR, Laitano O. Exertional heat stroke: Pathophysiology and risk factors. BMJ Med. 2022;1(1):e000239. DOI: 10.1136/bmjmed-2022-000239.

Fernandes PM, Davenport RJ. How to do it: Investigate exertional rhabdomyolysis (or not). Pract Neurol. 2019;19(1):43-8. DOI: 10.1136/practneurol-2018-002008.

Leyk D, Hoitz J, Becker C, Glitz KJ, Nestler K, Piekarski C. Health risks and interventions in exertional heat stress. Dtsch Arztebl Int. 2019;116(31-32):537-44. DOI: 10.3238/arztebl.2019.0537.

Adnan Bukhari H. A systematic review on outcomes of patients with heatstroke and heat exhaustion. Open Access Emerg Med. 2023;15:343-54. DOI: 10.2147/OAEM.S419028.

Stanley M, Chippa V, Aeddula NR, Rodriguez BSQ, Adigun R. Rhabdomyolysis [Internet]. 2024 [cited 2024 March 24]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448168/.

Sunder A, Mohanty B, Singh A, Yadav P. Rhabdomyolysis - Exercise induced nightmare. J Family Med Prim Care. 2019;8(1):305-7. DOI: 10.4103/jfmpc.jfmpc_370_18.

Shroff K, Gunasegaren M, Norbu K, Omar E. Clinical characteristics of spinning-induced rhabdomyolysis and other causes of rhabdomyolysis: A comparative study. Singapore Med J. 2022;63(10):567-71. DOI: 10.11622/smedj.2021116.

Jabur WL, Nasa P, Mohammed KA, Kulkarni A, Tomaraei SN. An observational epidemiological study of exercise-induced rhabdomyolysis causing acute kidney injury: A single-center experience. Indian J Nephrol. 2018;28(2):101-4. DOI: 10.4103/ijn.IJN_350_16.

Scalco RS, Snoeck M, Quinlivan R, Treves S, Laforet P, Jungbluth H, et al. Exertional rhabdomyolysis: Physiological response or manifestation of an underlying myopathy? BMJ Open Sport Exerc Med. 2016;2(1):e000151. DOI: 10.1136/bmjsem-2016-000151.

Downloads

Published

07-07-2025

How to Cite

David Kristianus, & Jonkie Budi Tirtadjaja. (2025). A 23-year-old Healthy Male with Syncope after Playing Futsal: A Case of Exertional Rhabdomyolysis: Case Report. Cermin Dunia Kedokteran, 52(7), 480–483. https://doi.org/10.55175/cdk.v52i7.1508