Rhabdomyolysis and acute pancreatitis

Aims: To establish the incidence of rhabdomyolysis in patients with acute p ancreatitis and to determine the effectiveness of myoglobin in assessing th e severity of the disease. Methods: Sixty-one patients having acute pancreatitis (33 males, 28 females , mean age 66 years, range 16-97 years) were studied; diagnosis of acute pa ncreatitis was based on the typical abdominal pain associated with elevated concentrations of serum lipase and further confirmed by imaging techniques . Rhabdomyolysis was defined as a level of serum myoglobin which is two or more times greater than the upper normal test limit. All patients had norma l renal function at the rims of the study, none had clinical and/or electro cardiographic signs of acute myocardial infarction and none were drug addic ts. Forty-five patients had mild acute pancreatitis and 16 had the severe f orm of the disease. Serum myoglobin was determined using a nephelometric te chnique. Results: Patients with mild pancreatitis had serum concentrations of myoglo bin (median and range; 35.7, 24-713 mu g/L) similar to those: with severe p ancreatitis (20.8, 24-710 mu g/L). Twelve of the 61 patients with acute pan creatitis (20%) had serum myoglobin concentrations above the upper normal l imit: sight of the 45 patients with mild pancreatitis (17.7%) and four of t he 10 patients with severe pancreatitis (25.0%). Four of the 61 patients wi th acute pancreatitis (7%) had serum myoglobin levels more than twice the u pper normal limit: two with mild disease and two with the severe form of pa ncreatitis. Conclusions: Rhabdomyolysis may occur asymptomatically in patients with acu te pancreatitis, especially in those with the severe form of che disease. S erum myoglobin determination is not useful in establishing the severity of acute pancreatitis.