{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T16:26:14Z","timestamp":1764433574881,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T00:00:00Z","timestamp":1732060800000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Rhabdomyolysis (RM) is characterised by the breakdown of skeletal muscle tissue, releasing toxic intracellular components into circulation. It presents with dark urine, muscle weakness, myalgia, and elevated creatine phosphokinase levels (CPK). Drug-induced RM is aetiologically significant. This case report describes a 25-year-old male who developed severe RM and Acute Kidney Injury (AKI) after intramuscular (IM) heroin administration as a first time user. IM heroin use can induce higher CPK levels due to direct myocyte toxicity and mechanical trauma. The highly vascularised gluteal muscles with type 1 fibres at the injection site likely exacerbated the severity. Additional factors included lower mitochondrial density in males and alcohol exposure. Despite aggressive fluid resuscitation, renal replacement therapy (RRT) was required, and the patient responded well to haemodialysis. This case highlights AKI as a severe complication of IM heroin use, underscoring the need for further research into drug-induced RM.<\/jats:p>","DOI":"10.1093\/omcr\/omae134","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T08:40:50Z","timestamp":1732092050000},"source":"Crossref","is-referenced-by-count":1,"title":["Intramuscular heroin-induced severe rhabdomyolysis and acute kidney injury\u2014a case report"],"prefix":"10.1093","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0822-9454","authenticated-orcid":false,"given":"Nikolay","family":"Dimov","sequence":"first","affiliation":[{"name":"UMHAT \u201cSveti Georgi\u201d Clinic of Nephrology, , Plovdiv, 15 Vasil Aprilov Blvd., 4002,","place":["Bulgaria"]},{"name":"Second Department of Internal Diseases, Section of Nephrology, Medical University of Plovdiv , Plovdiv, 15 Vasil Aprilov Blvd., 4002,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahsin","family":"Sultana","sequence":"additional","affiliation":[{"name":"Medical University of Plovdiv , Plovdiv, 15 Vasil Aprilov Blvd., 4002,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0262-1082","authenticated-orcid":false,"given":"Aishah","family":"Dafeeah","sequence":"additional","affiliation":[{"name":"Medical University of Plovdiv , Plovdiv, 15 Vasil Aprilov Blvd., 4002,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafsa","family":"Choudhury","sequence":"additional","affiliation":[{"name":"Medical University of Plovdiv , Plovdiv, 15 Vasil Aprilov Blvd., 4002,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitar","family":"Nikolov","sequence":"additional","affiliation":[{"name":"UMHAT \u201cSveti Georgi\u201d Clinic of Nephrology, , Plovdiv, 15 Vasil Aprilov Blvd., 4002,","place":["Bulgaria"]},{"name":"Second Department of Internal Diseases, Section of Nephrology, Medical University of Plovdiv , Plovdiv, 15 Vasil Aprilov Blvd., 4002,","place":["Bulgaria"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,20]]},"reference":[{"key":"2024112007580652800_ref1","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1007\/s00415-019-09185-4","article-title":"A systematic review on the definition of rhabdomyolysis","volume":"267","author":"Stahl","year":"2020","journal-title":"J Neurol"},{"key":"2024112007580652800_ref2","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ejim.2006.09.020","article-title":"The syndrome of rhabdomyolysis: pathophysiology and diagnosis","volume":"18","author":"Giannoglou","year":"2007","journal-title":"Eur J Intern Med"},{"key":"2024112007580652800_ref3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1519\/SSC.0000000000000106","article-title":"Rhabdomyolysis: considerations for recognition and prevention for practitioners","volume":"36","author":"Ramos","year":"2014","journal-title":"Strength Cond J"},{"key":"2024112007580652800_ref4","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.drudis.2018.06.006","article-title":"Drug-induced rhabdomyolysis atlas (DIRA) for idiosyncratic adverse drug reaction management","volume":"24","author":"Wen","year":"2019","journal-title":"Drug Discov Today"},{"key":"2024112007580652800_ref5","doi-asserted-by":"crossref","first-page":"17693","DOI":"10.1038\/s41598-023-45031-4","article-title":"Incidence of rhabdomyolysis occurrence in psychoactive substances intoxication: a systematic review and meta-analysis","volume":"13","author":"Amanollahi","year":"2023","journal-title":"Sci Rep"},{"key":"2024112007580652800_ref6","doi-asserted-by":"crossref","first-page":"e0246297","DOI":"10.1371\/journal.pone.0246297","article-title":"Euro-DEN research group; Dargan PI, Sein Anand J. Rhabdomyolysis related to acute recreational drug toxicity-a euro-DEN study","volume":"16","author":"Waldman","year":"2021","journal-title":"PLoS One"},{"key":"2024112007580652800_ref7","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2174\/157488406775268219","article-title":"Pharmacokinetics and pharmacokinetic variability of heroin and its metabolites: review of the literature","volume":"1","author":"Rook","year":"2006","journal-title":"Curr Clin Pharmacol"},{"key":"2024112007580652800_ref8","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-021-00584-3","article-title":"One prick and then it\u2019s done: a mixed-methods exploratory study on intramuscular injection in heroin-assisted treatment","volume":"18","author":"Meyer","year":"2021","journal-title":"Harm Reduct J"},{"key":"2024112007580652800_ref9","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/BF00294224","article-title":"Heroin-induced myopathy in rat skeletal muscle","volume":"80","author":"Pe\u00f1a","year":"1990","journal-title":"Acta Neuropathol"},{"key":"2024112007580652800_ref10","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.26603\/001c.29592","article-title":"The reliability and validity of gluteal endurance measures (GEMs)","volume":"16","author":"Lehecka","year":"2021","journal-title":"Int J Sports Phys Ther"},{"key":"2024112007580652800_ref11","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1186\/cc13897","article-title":"Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review","volume":"18","author":"Petejova","year":"2014","journal-title":"Crit Care"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2024\/11\/omae134\/60762188\/omae134.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2024\/11\/omae134\/60762188\/omae134.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T08:40:56Z","timestamp":1732092056000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omae134\/7904667"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":11,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omae134","relation":{},"ISSN":["2053-8855"],"issn-type":[{"type":"electronic","value":"2053-8855"}],"subject":[],"published-other":{"date-parts":[[2024,11]]},"published":{"date-parts":[[2024,11,1]]},"article-number":"omae134"}}