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      Case Report: Exertional rhabdomyolysis in a spin class participant with sickle cell trait

      case-report
      1 , a , 2
      F1000Research
      F1000 Research Limited
      Rhabdomyolysis, Spin class, Sickle cell trait

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          Abstract

          Exertional rhabdomyolysis is more common in sickle trait due to a predisposition to dehydration and inability to concentrate the urine. Spinning, an indoor cycling workout, has been associated with exertional rhabdomyolysis in recent reports. A consequence of rhabdomyolysis is acute kidney injury, which may be expected to be more common in patients with sickle trait. We report a case of spinning induced rhabdomyolysis in a woman with sickle trait that did not result in renal injury. “Spin rhabdo” is thought to be more severe than other causes of exertional rhabdomyolysis and is associated with higher creatine kinase levels than other causes of exertional rhabdomyolysis. Therefore, individuals with known sickle trait should consider visiting their physician prior to participation in spin classes for the first time. We might also consider voluntary screening for sickle trait in at risk populations prior to enrolling in spin classes given that many patients are unaware of their sickle trait status.

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          Rhabdomyolysis and acute kidney injury.

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            Creatine-Kinase- and Exercise-Related Muscle Damage Implications for Muscle Performance and Recovery

            The appearance of creatine kinase (CK) in blood has been generally considered to be an indirect marker of muscle damage, particularly for diagnosis of medical conditions such as myocardial infarction, muscular dystrophy, and cerebral diseases. However, there is controversy in the literature concerning its validity in reflecting muscle damage as a consequence of level and intensity of physical exercise. Nonmodifiable factors, for example, ethnicity, age, and gender, can also affect enzyme tissue activity and subsequent CK serum levels. The extent of effect suggests that acceptable upper limits of normal CK levels may need to be reset to recognise the impact of these factors. There is a need for standardisation of protocols and stronger guidelines which would facilitate greater scientific integrity. The purpose of this paper is to examine current evidence and opinion relating to the release of CK from skeletal muscle in response to physical activity and examine if elevated concentrations are a health concern.
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              Sickle Cell Trait, Rhabdomyolysis, and Mortality among U.S. Army Soldiers

              Studies have suggested that sickle cell trait elevates the risks of exertional rhabdomyolysis and death. We conducted a study of sickle cell trait in relation to these outcomes, controlling for known risk factors for exertional rhabdomyolysis, in a large population of active persons who had undergone laboratory tests for hemoglobin AS (HbAS) and who were subject to exertional-injury precautions.
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                Author and article information

                Contributors
                Role: Writing – Original Draft PreparationRole: Writing – Review & Editing
                Role: ConceptualizationRole: Supervision
                Journal
                F1000Res
                F1000Res
                F1000Research
                F1000Research
                F1000 Research Limited (London, UK )
                2046-1402
                1 July 2019
                2018
                : 7
                : 1742
                Affiliations
                [1 ]Albert Einstein College of Medicine, Bronx, NY, 10461, USA
                [2 ]Department of Internal Medicine, Montefiore Medical Center, Bronx, NY, 10467, USA
                [1 ]The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
                [2 ]Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of Health Sciences, Bethesda, USA
                [1 ]Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA
                [1 ]The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
                [2 ]Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of Health Sciences, Bethesda, USA
                [1 ]Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA
                Author notes

                No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Competing interests: No competing interests were disclosed.

                Author information
                https://orcid.org/0000-0003-3950-4014
                https://orcid.org/0000-0001-5853-2497
                Article
                10.12688/f1000research.16326.2
                6659762
                31372209
                14ac63d0-239a-4cd6-90e7-ddb5430b4eee
                Copyright: © 2019 Longo T and Shaines M

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 June 2019
                Funding
                The author(s) declared that no grants were involved in supporting this work.
                Categories
                Case Report
                Articles

                rhabdomyolysis,spin class,sickle cell trait
                rhabdomyolysis, spin class, sickle cell trait

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