Exercise-Induced Rhabdomyolysis with Acute Renal Failure After Strenuous Push-UPS.

This is a case of a 33 years old Chinese lady who was previously healthy. Her lifestyle was sedentary (clerical job). Her weight was 60 kg and height 1.63 m (BMI 22.6 kg/m2). During a company motivation course she was instructed by the speaker to do 90 push-ups as a penalty for losing in one of the events. She admitted that it was tough but she managed to complete the push-ups over 5-10 minutes, urged on by her colleagues. She did the exercise at 2.00 pm and by 8.00 to 10.00 pm the same evening she complained of body aches and passed dark coloured urine. Following that, she had symptoms of lethargy, muscular weakness and nausea. She attributed it to ‘heat’ and did not seek medical attention. The aches were unbearable on the following night and she went to a nearby 24 hour clinic to obtain some analgesics. On the 4th day after the episode she decided to see her regular family physician. On consultation, her chief complains were lethargy, mild nausea and soreness of the arms, chest wall and abdomen. She brought with her a bottle of red coloured urine (Fig 1). She had no fever, frequency of urination or dysuria. She had her period well over a week before. She had not taken any drugs or alcohol prior to the episode. She gave no history of genetic disorders.