Document Detail

Cocaine-associated rhabdomyolysis and excited delirium: different stages of the same syndrome.
MedLine Citation:
PMID:  10414649     Owner:  NLM     Status:  MEDLINE    
Previous case reports indicate that cocaine-associated rhabdomyolysis and excited delirium share many similar features, suggesting that they may be different stages of the same syndrome. We tested this hypothesis by comparing data from 150 cases of cocaine-associated rhabdomyolysis reported in the medical literature with data from an autopsy registry for 58 victims of fatal excited delirium and 125 victims of fatal acute cocaine toxicity. Patients with rhabdomyolysis are similar to victims of fatal excited delirium with regard to age; gender; race; route of cocaine administration; the experiencing of excitement, delirium, and hyperthermia; and the absence of seizures. Compared with victims of fatal acute cocaine toxicity, patients with rhabdomyolysis are different with regard to each of these variables. Compared with victims of fatal acute cocaine toxicity, both victims of rhabdomyolysis and fatal excited delirium are more likely to be black, male, and younger; to have administered cocaine by smoking or injection; and to have experienced excitement, delirium, and hyperthermia; they are also less likely to have had seizures. Because cocaine-associated rhabdomyolysis and excited delirium have similar clinical features and risk factors, occur in similar populations of drug users, and can be explained by the same pathophysiologic processes, we conclude that they are different stages of the same syndrome. It appears that this syndrome is caused by changes in dopamine processing induced by chronic and intense use of cocaine rather than by the acute toxic effects of the drug.
A J Ruttenber; H B McAnally; C V Wetli
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  The American journal of forensic medicine and pathology     Volume:  20     ISSN:  0195-7910     ISO Abbreviation:  Am J Forensic Med Pathol     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-09-03     Completed Date:  1999-09-03     Revised Date:  2011-02-02    
Medline Journal Info:
Nlm Unique ID:  8108948     Medline TA:  Am J Forensic Med Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  120-7     Citation Subset:  IM    
Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, Denver 80262, USA.
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MeSH Terms
Acute Kidney Injury / etiology
Cocaine-Related Disorders / complications*
Delirium / etiology*
Disseminated Intravascular Coagulation / etiology
Liver Failure / etiology
Rhabdomyolysis / etiology*
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