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Continuous Venovenous Hemodiafiltration for Life-threatening Mitochondrial Myopathy With Lactic Acidosis and Rhabdomyolysis

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan, caf55000{at}pop12.odn.ne.jp

Masao Nagayama, MD

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan, Department of Neurology, Tokai University School of Medicine, Kanagawa, Japan, Department of Neurology, Yokohama Stroke and Brain Center, Kanagawa, Japan

Hiromichi Aoki, MD

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan

Kozo Tamura, MD

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan

Yosuke Suzuki, MD

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan

Seiji Morita, MD

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan

Yoshihide Nakagawa, MD

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan

Isotoshi Yamamoto, MD

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan

Sadaki Inokuchi, MD

Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Kanagawa, Japan

We report here the clinical course of a 31-year-old male who recovered from a fulminant form of mitochondrial myopathy with lactic acidosis. The patient was transferred to our hospital with acute dyspnea and a convulsive seizure. On admission, he was in a state of shock, and presented with severe high-output heart failure, acute renal failure, and rhabdomyolysis. Treatment with continuous venovenous hemodiafiltration (CVVHDF) resulted in an excellent response, with no signs of hemodynamic instability. This case suggests that CVVHDF with serial hemodynamic monitoring may be effective in treating hypotensive patients with a life-threatening mitochondrial disorder.

Key Words: mitochondrial myopathy • rhabdomyolysis • lactic acidosis • continuous venovenous hemodiafiltration

Journal of Intensive Care Medicine, Vol. 22, No. 4, 240-244 (2007)
DOI: 10.1177/0885066607301343


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