Rhabdomyolysis after strenuous exercise: A case report.

Rhabdomyolysis is a syndrome characterized by necrosis and the disruption of striated muscle fibers. It is secondary to etiologies, such as trauma, ischemia, or toxin exposure. Rhabdomyolysis releases intracellular muscle constituents into systemic circulation, frequently leading to acute kidney injury. Clinical manifestations, including muscle weakness, myalgia, and dark urine, in young adults with nontraumatic etiologies are frequently underrecognized. Early diagnosis and prompt intervention are critical for mitigating complications. We report a case of a 27-year-old male who was admitted to Shanghai Municipal Hospital of Traditional Chinese Medicine in September 2024, presenting with exertional rhabdomyolysis complicated by acute kidney injury. Serum myoglobin (>12,000 ng/mL) and creatine kinase (210,000 U/L) were strikingly elevated. Therapeutic intervention consisted of vigorous fluid resuscitation, urinary alkalinization, electrolyte correction, and combined intermittent renal replacement therapy and hemoperfusion. The patient recovered uneventfully and was discharged in stable condition. It highlights the vulnerability of young individuals to rhabdomyolysis and underscores the seriousness of the condition. The adjunctive use of intermittent renal replacement therapy combined with hemoperfusion was observed to reduce circulating creatinine and myoglobin levels, which may serve as a reference for future therapeutic decision-making.