Rasburicase Improves Hyperuricemia in Patients with Acute Kidney Injury Secondary to Rhabdomyolysis Caused by Ecstasy Intoxication and Exertional Heat Stroke

OBJECTIVE:To report the successful use of rasburicase in two children with hyperuricemia secondary to severe rhabdomyolysis.DESIGN:: Case report.SETTING:Pediatric intensive care unit in a freestanding quaternary hospital.PATIENTS:Two pediatric patients with severe rhabdomyolysis and hyperuricemia caused by ecstasy intoxication and exertional heat stroke.INTERVENTION:Use of a single low dose (6 mg) of rasburicase, a urate oxidase enzyme.MEASUREMENTS AND MAIN RESULTS:Rasburicase was administered on the first and second hospital days with a single low dose of 6 mg (0.086 mg/kg in patient A and 0.092 mg/kg in patient B). Within 24 hrs, the levels of serum uric acid in both patients decreased dramatically, and their creatinine levels decreased and urine output increased concurrently. Continuous improvements in the uric acid levels, creatinine levels, and urine output were noted during hospitalization.CONCLUSION:Rasburicase seems to be a safe and effective drug for improving hyperuricemia in patients with rhabdomyolysis and renal failure.