{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:06:16Z","timestamp":1783904776387,"version":"3.55.0"},"reference-count":21,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Carnitine palmitoyltransferase II deficiency (CPT II) is an autosomal recessive inherited disorder of long-chain fatty acid oxidation in the mitochondrial matrix, resulting in an inability to utilize fat for energy in cells. The most frequent myopathic form occurs in young adults and is associated with recurrent episodes of exercise-induced rhabdomyolysis. The myopathic form is caused by the Ser113Leu mutation of the CPT II gene. Rarely, massive rhabdomyolysis could be complicated by acute kidney injury (AKI), cardiomyopathy, and respiratory insufficiency.<\/jats:p>\n                  <jats:p>\n                    We present a case of an 18-year old male with myalgia, muscular weakness, and dark-colored urine after prolonged exercise and a recent mild\n                    <jats:italic>SARS-CoV-2<\/jats:italic>\n                    infection. Massive rhabdomyolysis was diagnosed with markedly increased serum concentrations of myoglobin and creatine kinase, with normal kidney function. The patient experienced two similar episodes in the years 2017 and 2018, with rhabdomyolysis and AKI treated with hemodialysis. After excluding autoimmune and infectious diseases as causes of recurrent rhabdomyolysis, the patient was genetically tested and Ser113Leu mutation of the CPT II gene was confirmed.\n                  <\/jats:p>\n                  <jats:p>\n                    When a patient presents with myalgia and dark-colored urine triggered by minor physical activities, genetic testing for possible CPT II deficiency should be initiated. The\n                    <jats:italic>SARS-CoV-2<\/jats:italic>\n                    infection could be a factor that triggers the occurrence of rhabdomyolysis and aggravates the severity of the attack in patients with CPT II deficiency.\n                  <\/jats:p>","DOI":"10.2478\/prilozi-2022-0037","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T16:34:20Z","timestamp":1670344460000},"page":"61-66","source":"Crossref","is-referenced-by-count":1,"title":["Rhabdomyolysis Associated with Recent\n                    <i>SARS-COV-2<\/i>\n                    Infection in a Patient with Carnitine Palmitoyltransferase II Deficiency"],"prefix":"10.2478","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6861-3992","authenticated-orcid":false,"given":"Irena","family":"Rambabova-Bushljetik","sequence":"first","affiliation":[{"name":"University Clinic of Nephrology , Un. Ss Cyril and Methodius , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavlina","family":"Dzekova-Vidimliski","sequence":"additional","affiliation":[{"name":"University Clinic of Nephrology , Un. Ss Cyril and Methodius , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlatko","family":"Karanfilovski","sequence":"additional","affiliation":[{"name":"University Clinic of Nephrology , Un. Ss Cyril and Methodius , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaklina","family":"Sterjova-Markovska","sequence":"additional","affiliation":[{"name":"University Clinic of Nephrology , Un. Ss Cyril and Methodius , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadil","family":"Cana","sequence":"additional","affiliation":[{"name":"University Clinic of Infectious disease , Un. Ss Cyril and Methodius , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Bushljetikj","sequence":"additional","affiliation":[{"name":"University Clinic of Cardiology , Un. Ss Cyril and Methodius , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Balkanov","sequence":"additional","affiliation":[{"name":"University Clinic of Hematology , Un. Ss Cyril and Methodius , Skopje , RN Macedoniam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Kapedanovska-Nestorovska","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Un. Ss Cyril and Methodius , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar","family":"Dimovski","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Un. Ss Cyril and Methodius , Skopje , RN Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,12,4]]},"reference":[{"key":"2026071212092456257_j_prilozi-2022-0037_ref_001","doi-asserted-by":"crossref","unstructured":"1. Almannai M, Alfadhel M, El-Hattab AW. Carnitine inborn errors of metabolism. Molecules. 2019 Sep 6; 24(18): 3251.10.3390\/molecules24183251676690031500110","DOI":"10.3390\/molecules24183251"},{"key":"#cr-split#-2026071212092456257_j_prilozi-2022-0037_ref_002.1","doi-asserted-by":"crossref","unstructured":"2. Joshi PR, Zierz S. Muscle carnitinepalmitoyltransferase II (CPT II) deficiency: A conceptual approach. 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Lab Invest. 2003 Nov; 83(11): 1543\u20131554.10.1097\/01.LAB.0000098428.51765.83","DOI":"10.1097\/01.LAB.0000098428.51765.83"},{"key":"2026071212092456257_j_prilozi-2022-0037_ref_005","doi-asserted-by":"crossref","unstructured":"5. Wongkittichote P, Watson J, Leonard J, Toolan E, Dickson P, Grange D. Fatal COVID-19 infection in a patient with long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency: A case report. JIMD Reports. 2020; 56(1): 40-45.10.1002\/jmd2.12165765324233204595","DOI":"10.1002\/jmd2.12165"},{"key":"2026071212092456257_j_prilozi-2022-0037_ref_006","doi-asserted-by":"crossref","unstructured":"6. Tan A, Stepien KM, Narayana STK. Carnitine palmitoyltransferase II deficiency and post-COVID vaccination rhabdomyolysis. QJM. 2021 Nov 5; 114(8): 596\u2013597.10.1093\/qjmed\/hcab077808320033871650","DOI":"10.1093\/qjmed\/hcab077"},{"key":"2026071212092456257_j_prilozi-2022-0037_ref_007","doi-asserted-by":"crossref","unstructured":"7. Angelini C. CarnitinePalmitoyltransferase II Deficiency. In: Genetic Neuromuscular Disorders. Springer, Cham. 2014. p. 285\u2013288.10.1007\/978-3-319-07500-6_64","DOI":"10.1007\/978-3-319-07500-6_64"},{"key":"2026071212092456257_j_prilozi-2022-0037_ref_008","doi-asserted-by":"crossref","unstructured":"8. Avila-Smirnow D, Boutron A, Beyt\u00eda-Reyes ML\u00c1, et al. Carnitine palmitoyltransferase type 2 deficiency: novel mutation in a Native South American family with whole-body muscle magnetic resonance imaging findings: two case reports. J Med Case Rep. 2018; 12(1): 249.10.1186\/s13256-018-1702-3611214630149802","DOI":"10.1186\/s13256-018-1702-3"},{"key":"2026071212092456257_j_prilozi-2022-0037_ref_009","doi-asserted-by":"crossref","unstructured":"9. Joshi PR, Deschauer M, Zierz S. Phenotype of carnitinepalmitoyltransferase II (CPT II) deficiency: A questionnaire-based survey. 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Blanc PL, Carrier H, Thomas L, Chavaillon JM, Robert D. Acute rhabdomyolysis with carnitine-palmitoyl-transferase deficiency. Intensive Care Med. 1982; 8(6): 307.10.1007\/BF017167467175018","DOI":"10.1007\/BF01716746"},{"key":"2026071212092456257_j_prilozi-2022-0037_ref_013","doi-asserted-by":"crossref","unstructured":"13. Gjorgjievski N, Dzekova-Vidimliski P, Petronijevic Z, Selim G, Dejanov P, Tozija L, et al. CarnitinePalmitoyltransferase II Deficiency (CPT II) Followed By Rhabdomyolysis and Acute Kidney Injury. Open Access Maced J Med Sci. 2018 Apr 12; 6(4): 666\u2013668.10.3889\/oamjms.2018.158592750029731937","DOI":"10.3889\/oamjms.2018.158"},{"key":"2026071212092456257_j_prilozi-2022-0037_ref_014","doi-asserted-by":"crossref","unstructured":"14. Vavlukis M, Eftimov A, Zafirovska P, Caparovska E, Pocesta B, Kedev S, et al. Rhabdomyolysis and Cardiomyopathy in a 20-Year-Old Patient with CPT II Deficiency. 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