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KMID : 0387720070180030265
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Korean Journal of Blood Transfusion
2007 Volume.18 No. 3 p.265 ~ p.268
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A Case of Removal Myoglobin by Plasmapheresis in Rhabdomyolysis.
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Jang Mi-Sook
Park Sung-Gong
Kwon Seog-Woon
Min Yu-Sun
Seo Hyeon-Ah
Ko Tae-Sung
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Abstract
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Rhabdomyolysis is defined as necrosis of the skeletal muscle fibers with release of the intracellular muscle constituents, including myoglobins,into the blood and urine. Severe myoglobinemia causes obstruction and necrosis of the renal tubule, resulting in acute renal failure (ARF). In this case, a patient with rhabdomyolysis-induced ARF was in recovery phase after treatment with fluid replacement and continuous renal replacement therapy (CRRT). However, a sudden relapse of severe myoglobinemia occurred during CRRT. To remove myoglobinas rapidly as possible, we applied two sessions of plasmapheresis (total plasma exchange, TPE) in addition to CRRT for two days. The myoglobin level of the patient successfully decreased by 91%, and clinical symptoms and laboratory-measuredabnormalities subsequently improved. If severe myoglobinemia is persistent, or if relapse in spite of CRRT occurs, it would be reasonable to consider TPEas an additional therapy.
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KEYWORD
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Rhabdomyolysis, Myoglobin, Plasmapheresis, TPE
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