A patient who abuses heroin may develop rhabdomyolysis.
Clinical features:
(1) myoglobinuria
(2) muscle pain with swelling and tenderness
(3) variable neurologic findings (plexitis, transverse myelitis, stroke, neuropathy, other)
(4) acute renal failure
(5) elevated serum CK
(6) hyperkalemia
Contributing factors may include:
(1) concomitant abuse of cocaine or methamphetamine
(2) compartment syndrome
Other causes of rhabdomyolysis need to be excluded, such as blunt trauma or limb compression.
