Emotional distress induced rhabdomyolysis in an individual with carnitine palmitolytransferase deficiency

Wallace, R. A., Klestov, A. C. and Kubler, P. A. (2001) Emotional distress induced rhabdomyolysis in an individual with carnitine palmitolytransferase deficiency. Clinical And Experimental Rheumatology, 19 5: 583-586.


Author Wallace, R. A.
Klestov, A. C.
Kubler, P. A.
Title Emotional distress induced rhabdomyolysis in an individual with carnitine palmitolytransferase deficiency
Journal name Clinical And Experimental Rheumatology   Check publisher's open access policy
ISSN 0392-856X
Publication date 2001
Sub-type Article (original research)
Volume 19
Issue 5
Start page 583
End page 586
Total pages 4
Place of publication Pisa, Italy
Publisher Pacini Editere
Collection year 2001
Language eng
Subject CX
320299 Immunology not elsewhere classified
730211 Mental health
Abstract A 48-year-old male patient with underlying CPT II enzyme deficiency is described. Emotional stress appeared to precipitate recurrent myalgias, rhabdomyolysis and reversible renal impairment over a 40-year period. Our search of the English literature indicates this to be the first time that the emotional stress has been documented to precipitate the CPT II syndrome. Although the pathogenesis of this syndrome has yet to be established, existing knowledge is briefly reviewed and the likely metabolic and neuroendocrine mechanisms which link emotional stress to muscle metabolism are examined. These mechanisms influence the extent of lipolysis or glycolysis that occurs during the process of muscle ATP generation. It is suggested that neuroendocrine and other stress related changes which favour lipolysis over glycolysis adversely effect muscle energy metabolism in patients whose mitochondria are deficient in CPT II enzyme. Possible treatment strategies are those that favour glycolysis over fatty acid metabolism and include a variety of ways of modulating sympathetic and parasympathetic tone. The use of carbohydrate supplementation P-blockers and anxiolytic agents is discussed.
Keyword Rheumatology
Cpt Deficiency
Emotional Stress
Rhabdomyolysis
Myalgia
Palmitoyl Transferase Deficiency
Myoglobinuria
Stress
Q-Index Code CX

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 14 Aug 2007, 16:44:11 EST