Rhabdomyolysis and myoglobinuria are a rare complication of dermatomyositis. Rhabdomyolysis has a wide range of presentations, from asymptomatic to life-threatening. The most dramatic presentation can result in acute renal failure, electrolyte imbalances, and/or disseminated intravascular coagulation (DIC). Recognition of this fact has important therapeutic implications as patients require immunotherapy in addition to the symptomatic treatment for renal failure. Here we present a 30 year old male banker presented with progressive muscle pain and weakness for 10 days and high colored urine for 3 days. Laboratory findings suggested rhabdomyolysis. A diagnosis of dermatomyositis was based upon the proximal muscle weakness on both upper and lower limbs, skin lesion over face and upper trunk, elevated muscle enzyme levels, muscle biopsy and skin biopsy findings. The patient was managed with high dose prednisolone and steroid sparing agent. His muscle power did improve slightly. In our view, this is an interesting case in that dermatomyositis cause fulminant rhabdomyolysis without causing myoglobinuric acute kidney injury (AKI) due to direct toxic effect of myoglobulin on renal tubule.

Keywords: Dermatomyositis; Myoglobinuria; Rhabdomyolysis; Acute kidney injury