American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs

Freebie Rhabdomyolysis: A Public Health Concern. Spin Class-Induced Rhabdomyolysis

A representative hematoxylin & eosin-stained section reveals several tubules dilated with eosinophilic granulated cast focally surrounded by desquamated epithelial cells. Many of the surrounding tubules show nonspecific degenerative changes suggestive of acute tubular injury. Glomeruli and blood vessels are essentially unremarkable (original magnification ×25).

A representative hematoxylin & eosin-stained section reveals several tubules dilated with eosinophilic granulated cast focally surrounded by desquamated epithelial cells. Many of the surrounding tubules show nonspecific degenerative changes suggestive of acute tubular injury. Glomeruli and blood vessels are essentially unremarkable (original magnification ×25).

Rhabdomyolysis is a pathologic condition in which intracellular muscle constituents leak into the blood circulation. It is usually caused by muscle trauma. “Spinning” is an indoor form of cycling where participants use a special stationary exercise bicycle with a weighted flywheel and undergo high-intensity cycling classes focusing on endurance. There have been several case reports in the literature of exertional rhabdomyolysis following spin class.

Methods

Our nephrology practices have diagnosed a number of cases of symptomatic patients presenting to our emergency departments following their first spin classes, with histories and creatinine phosphokinase levels diagnostic of exertional rhabdomyolysis.

Results

We present 3 unusual cases of exertional rhabdomyolysis, each occurring after a first spin class. In the first case, rhabdomyolysis developed following 15 minutes of spin class. In the second case, it occurred in a young individual who exercises regularly. In the third case, the patient developed biopsy-proved acute kidney injury secondary to exertional rhabdomyolysis and required hemodialysis.

Conclusion

The high-intensity exercise associated with “spin class” comes with significant risks to newcomers.

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-Maureen Brogan, MD, Rudrick Ledesma, MD, Alan Coffino, MD, PhD, Praveen Chander, MD

This article originally appeared in the April 2017 issue of The American Journal of Medicine.

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