PEDIATRICS Vol. 84 No. 2 August 1989, pp. 312-316
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Fatal Rhabdomyolysis Following Influenza Infection in a Girl With Familial Carnitine Palmityl Transferase Deficiency

Kevin J. Kelly MD1, Jeffery S. Garland MD1, Thomas T. Tang MD, PhD1, Austin L. Shug PhD1, and Michael J. Chusid MD1

1 The Department of Pediatrics and Pathology, Children's Hospital of Wisconsin and the Medical College of Wisconsin, Milwaukee

Severe rhabdomyolysis following an influenza B infection developed in a previously well 13-year-old girl. There was no history of trauma. Her course was complicated by episodes of severe hyperkalemia, hypocalcemia, hyperphosphatemia, and myoglobinuria. Renal failure, hypertension, and life-threatening arrhythmias developed; she died. Muscle biopsy revealed that this girl had carnitine palmityl transferase deficiency. An asymptomatic sister was demonstrated to have the same disorder. Although carnitine palmityl transferase deficiency is usually associated with mild bouts of rhabdomyolysis that become apparent only in adulthood, severe forms of this disorder may be seen in children. Life-threatening rhabdomyolysis and myoglobinuria may follow any infection associated with decreased intake. If carnitine palmityl transferase deficiency is diagnosed in a proband, other siblings should be evaluated so that proper preventative measures can be undertaken to help prevent the development of symptoms in susceptible individuals who have not been recognized to have the disease.

Key Words: myoglobinuria • rhabdomyolysis • influenza B • carnitine palmityl transferase deficiency

Submitted on February 23, 1988
Accepted on July 28, 1988




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