ChrisPAinED Posted December 15, 2022 Share Posted December 15, 2022 First off I am back to the forum had a lot of stuff to take care of. How has everyone doing? Anyway this thread is dedicated to the patient with the highest CK you have ever heard about or seen. I have had a patient on my first week working ICU that was admitting rhabdomyolysis with a CK of 19,800 u/l and that was the highest I have ever seen. Treated with lots of fluids and pain management also kidney function started tanking but after about 2 days kidney damage was done and not occuring anymore and pt was discharged after 5 days when it dropped below 10K with followup with nephrology and PCP. Cause: excessive exercise follow up CK: last one I saw 204. Interesting one. What was your highest Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted December 15, 2022 Moderator Share Posted December 15, 2022 I rarely see rhabdo in the well conditioned, but usually it’s in someone who wasn’t use to working out and then went hard. I can’t really recall the highest. I know it was more than 50k. Military studies show marines gets up to 20k after a physical fitness test pretty commonly. If it’s not over 5k I don’t even think about it except as a reason they may have an AST bump (muscles contain ast and alt, yet someone always ends up doing a RUQ Us on these people) 1 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 15, 2022 Moderator Share Posted December 15, 2022 A friend of mine, a military PA who should have known better, was doing cross fit drills with his unit in the desert and not drinking enough. His CK was > 80,000 (higher than upper level of assay). He was in the hospital for several days and made a full recovey. We all stopped by to give him a hard time. 1 1 Quote Link to comment Share on other sites More sharing options...
Mayamom Posted December 15, 2022 Share Posted December 15, 2022 I had a women when I was in the prison system who averaged 10-15,000. She was a chronic cocaine user no exercise involved. I believe someone placed her on Methotrexate for this. Quote Link to comment Share on other sites More sharing options...
ChrisPAinED Posted December 15, 2022 Author Share Posted December 15, 2022 6 hours ago, EMEDPA said: A friend of mine, a military PA who should have known better, was doing cross fit drills with his unit in the desert and not drinking enough. His CK was > 80,000 (higher than upper level of assay). He was in the hospital for several days and made a full recovey. We all stopped by to give him a hard time. Happy endings and glad he was okay Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted December 15, 2022 Share Posted December 15, 2022 I can't recall the final number, just that the lab said that they had done 3 dilutions before they could give me a ballpark number. Cr wasn't terrible, so my ED thought process was: fluid bolus: 2 L NS, 1 L LR, => continuous LR, => hospitalist's problem. I believe there was a nephrology consult who said emergent dialysis wasn't needed. Don't recall if that was to anticipate questions from the hospitalist or not. 1 Quote Link to comment Share on other sites More sharing options...
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