Rhabdomyolysis in diabetic ketoacidosis
B. A. Buckingham, T. F. Roe and J. W. Yoon
A 2-year-old boy became ill with diabetic ketoacidosis complicated by
severe rhabdomyolysis. He completely recovered from the rhabdomyolysis, but
has persistent insulin-dependent diabetes mellitus (IDDM). Serological
studies showed that the patient's serum contained high titers of
coxsackievirus B4 antibody, suggesting that the development of
rhabdomyolysis and IDDM may have been related to this infection. A review
of the records of 133 patients admitted with onset of IDDM disclosed one
additional patient with marked myoglobinuria, and 11 patients with
orthotolidine-positive urine in the absence of hematuria. These findings
suggest that myoglobinuria may not be uncommon at the onset of IDDM.