Abstract
Background
Rhabdomyolysis is a syndrome characterized by muscle necrosis and the entry of myocyte contents into the circulation. Creatine kinase (CK) levels are usually significantly elevated in this syndrome. In psychiatry, it is common to find patients with creatine kinase (CK) levels significantly higher than normal values, sometimes exceeding 10 times the upper limit. This CK elevation may be due to the occurrence of rhabdomyolysis. Severe rhabdomyolysis can lead to acute kidney injury, which can be life-threatening.
Case presentation:
This report describes the case of a 54-year-old woman with catatonic schizophrenia with a stupor who was admitted to the hospital without CK elevation or muscle damage but developed rhabdomyolysis after protective restraint. The patient had no history of traumatic or exertional illness prior to admission and no family history of rhabdomyolysis. After fluid resuscitation, the patient's rhabdomyolysis resolved. In addition, in combination with modified electroconvulsive therapy (MECT), the patient’s stupor symptoms disappeared.
Conclusions
This case suggests that psychiatrists should be aware of rhabdomyolysis when treating patients with acute schizophrenia who may require additional restraints. Severe rhabdomyolysis can be life-threatening. Therefore, when protective restraints are needed, psychiatrists should strictly follow the guidelines for protective restraint use to avoid additional harm to patients owing to medical reasons.