Table 1 Case reports about methadone induced rhabdomyolysis and AKI
Author | Age/gender | Methadone dose | Primary signs and symptoms | Lab parameters | Outcome |
|---|---|---|---|---|---|
Hojs and Sinkovic (1992) | 28/Male | 30 mg IV | Comatose, cyanotic congenital heart disease, and shallow breathing, anuria | Urea: 124 mg/dl Creatinine: 2.18 mg/dl Myoglobin-positive urine. CK: 12,000 U/L | Discharged in good condition |
Chakera (2008) | 30/Male | 120 mg | Unconsciousness | CK: “increased” Metabolic acidosis, anuria. | After 7 sessions of dialysis, renal function started to recover. |
Hsu et al. (2009) | 33/Male | 150 mg/day (heroin user) | Unconsciousness | CK: 17,680 U/L, Cr: 2.9 mg/dl myoglobin: >4000 | Cerebral ischemic infarction |
Nanji and Douglas Filipenko (1983) | 31/Male | “Large amount” of methadone | Respiratory distress, but awake | BUN: 24 mg/dl, Creatinine: 2.2 mg/dl CK: 7500 U/L. | Recovered |
Gramenz et al. (2010) | Not mentioned | 10-mg methadone tablets dissolved in water and injected into femoral artery | Severe pain and leg cyanosis. No unconsciousness | CK: 4208 U/L. | Responded to medical therapy |
Valga-Amado et al. 2012 | 41/Male | Muscle weakness and widespread myalgia, Reduced consciousness | Creatinine: 2.88 mg/dl; CK: 86,000 IU/l. | Recovered | |
Mittal et al. | 38/Male | Methadone and diazepam ingestion | Unconsciousness methadone-induced delayed posthypoxic encephalopathy | CK: 3339 IU/l BUN: 13 mg/dl Creatinine: 3.2 mg/dl (diagnosis of AKI was made). | Treated successfully with combination of steroids and antioxidants |
Weston et al. | 27/Male | Not mentioned | Unconsciousness | CK: 31,500 u/l Urine osmolality: 292 mosmol/l (diagnosis of AKI was made) | Full recovery |
David et al. 1 | 24/Male | 40 mg IV | Comatose, Shallow breathing, pulmonary edema | BUN: 62 mg/dl Creatinine: 3.9 mg/dl. CK: 6750 IU/l | Discharged in good condition |
David et al. 2 | 25/Male | 50 mg /IV | Apneic, comatose, pulmonary edema | BUN: 132 mg/dl Creatinine: 5.2 mg/dl CK: 190 IU /L | Died |