To provide the best experiences, we use technologies like cookies to store and/or access device information. Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. Not consenting or withdrawing consent, may adversely affect certain features and functions.
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.
The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
Hi Julia
Benign Acute Childhood Myositis – share with you some facts and my personal practice.
· Very common in children and benign. Many have a bit of aches and pains, not necessarily need a blood test, many stayed in the community and not referred.
Flu virus is a common associated agent, but all viruses could do it.
Eat and drink, IV fluids really not necessary, reassure.
· A note on Rhabdomyolysis
If CK is high with muscle pain, acute onset, please ask for a urine dipstick.
Urine colour may not be a sensitive marker and very subjective.
Myoglobin will turn urine dipstick positive on the ‘blood’ section.
In acute rhabdomyolysis, there is myoglobinuria, urine dipstick will show 4+ of blood. CK will be very high> 10000
Adolescent with good muscle bulk could have a very high CK,> 100000, last case I had CK 240000!
Hyperhydrate with IV + oral fluids twice the normal maintenance at least if no pre-existing heart problem.
This is to prevent myoglobin clogging the renal tubules, lead to renal failure
This is an unusual general paeds emergency condition, diagnosis can be delayed.
GOSH nephrology will not take the patient unless there is renal failure.
if there is renal failure, it means the diagnosis is delayed and failure to initiate hyper-hydration treatment early to prevent complications
· Do we need to repeat CK in 3-4 weeks to ensure complete resolution of the condition?
It is a clinical judgement. If symptoms have completely resolved and clinically well, probably no.
The indication to repeat is when the diagnosis is uncertain, ie if symptoms persists, and to look for evidence dermatomyositis/ overlap syndrome.
John
Paediatric Consultant, Bartshealth NHS Trust
Nice one