Athletics meeting

In this text, we emphasize that ALPE should always be considered in patients who complain of severe loin pain and nausea after sprinting in an athletics meeting, and while ALPE frequently develops in patients with renal hypouricemia, it also develops in those without it. 

A 24-year-old man (Patient 3). This patient had flu-like symptoms, and took a mixed preparation consisting of bucetin at 120 mg and aspirin at 240 mg. After 15 h, he participated in a 200-m race in an athletics meeting (October 10, 1980). After 6h, he attended our hospital with nausea and bilateral loin pain. The severe pain, which made it impossible for him to drive a car, persisted for 2 days. His serum creatinine and urinary protein levels were 2.4mg/dl and 2+, respectively, 4 days after onset. The patient was negative for urinary occult blood, and his urinary sodium level was 99mEq/l. On the same day, drip infusion pyelography (DIP) revealed no ureteral... 

In relation to the term exercise-induced acute renal failure, this disorder was expressed as loin pain and acute renal failure after exercise (athletics meeting) in 1981 [24] (Fig. 24). Later, however, Nishimura and Takahara [25], Ishii et al. [26], and Nakamura et al. [27] named this disorder exercise-induced acute renal failure. Since then, this term has commonly been used [3]. 

Fig. 24. A copy of the description of ALPE published in Igaku-No-Ayumi (J Clin Exp Med). Topics loin pain and acute renal failure after exercise (athletics meeting). When patients with this new syndrome come to an emergency room complaining of loin pain, they are often misdiagnosed as having radio-lucent urolithiasis. When a patient complains of severe loin pain after unaccustomed violent exercise at an athletics meeting or during summer bathing, in particular after taking a nonsteroidal anti-inflammatory drug (NSAID) for flu-like symptoms, this new syndrome should be suspected. In addition, the patient s serum creatinine level must be measured. (From [24], with permission)...

This patient was the first case in our series in which acute renal failure developed after an athletics meeting. After he had participated in a 200-m race, loin pain occurred, leading to acute renal failure. Delayed computed tomography (CT) showed diffuse to patchy contrast enhancement. The details are given in Chap. 2, Sect. 2. 

This patient was the first case in which ALPE developed in the presence of renal hypouricemia [3]. On September 26,1984, he participated in a 400-m race in a school athletics meeting. On September 27, nausea and vomiting occurred about 12 h later at 0100 hours, and then bilateral loin pain and abdominal pain developed. Because... 

This patient participated in a 200-m relay race at an athletics meeting on October 10. After dinner, a dull pain in his left flank occurred and gradually worsened, but it differed from colic. There was no decrease in urine volume or dark urine. At 2330 hours, the patient attended the Emergency Outpatient Unit of our hospital because of the pain. An intramuscular injection of scopolamine butylbromide relieved the... 

This patient was the first case in our series in which ALPE was detected with acute renal failure due to unknown etiology. On September 19,1976, he ran two 100-m races at an athletics meeting. On September 20, vomiting, diarrhea, and upper abdominal pain developed, and the patient attended our department. His serum creatinine and uric acid levels were 5.0 mg/dl and 17.0 mg/dl, respectively. The pain persisted for 1... 

This patient, who had ADPKD, developed ALPE after a sprint. On October 1,1995, he participated in two 100-m races at an athletics meeting in the morning. After a few hours, severe loin pain occurred, and he attended our department the following morning. There were no other abnormal findings, and his blood pressure, pulse, and serum creatinine values were 120/66 mmHg, 64/min, and 1.6mg/dl (serum creatinine level before onset 0.9mg/dl), respectively. On October 2, delayed CT 4 and 24 h after the administration of contrast medium showed patchy lesions (Fig. 37). On October 14, his serum creatinine level returned to 1.1 mg/dl, and CT 4h after the administration of contrast medium showed no contrast enhancement. 

This patient (Case 1 in Fig. 57) and his son developed ALPE in the presence of renal hypouricemia [36]. After two 150-m sprints and rope skipping (40 skips) in a town athletics meeting, he developed ALPE. Gene analysis was performed to check for renal hypouricemia. The patient s son also developed ALPE (Case 2 in Fig. 57). The details are given in Chap. 10, Sect. 1. 

This patient and his father (Patient 18) developed ALPE in the presence of renal hypouricemia [36] (Case 2 in Fig. 57). The son developed ALPE after participating in two 400-m races, a mock cavalry battle, and a tug of war in an athletics meeting. At a local clinic, a nonsteroidal anti-inflammatory drug (NSAID) was administered orally under a diagnosis of muscular pain, and the condition was exacerbated. Gene... 

The time of onset was often September or October, when many athletics meetings and sports festivals are held (Fig. 55). 

On June 6, this patient developed severe loin pain after he participated in two 150-m sprints at a town athletics meeting. After 5 days, he was referred to the outpatient clinic of our department. His serum creatinine and uric acid levels and FEUA, were 2.9mg/dl, 2.1 mg/dl, and 49.7%, respectively. His creatine phosphokinase (CPK) level was normal. When his serum creatinine level decreased to 1.58 mg/dl, a contrast medium was administered. A delayed computed tomography (CT) scan after 24 and 48 h confirmed patchy wedge-shaped contrast enhancement (Fig. 58). Under a diagnosis of ALPE, his body water balance (hydration) was controlled. In this patient, recovery was achieved 4 weeks after onset, and his serum creatinine and uric acid levels were then 1.0 mg/dl and 0.6 mg/dl, respectively. Furthermore, load tests with a uric acid reabsorption inhibitor (benzbromarone) and a uric acid excretion inhibitor (pyrazinamide) suggested presecretory reabsorption defect-related renal hypouricemia. A kidney biopsy 16 days after onset confirmed the recovery from acute tubular necrosis. 

This patient developed severe loin pain 3 h after he participated in two 400-m races, a mock cavalry battle, and a tug of war at an athletics meeting, and he attended a... 

Sprinting in an athletics meeting should be avoided if the athlete has a cold. 

If a renal hypouricemia patient with a serum uric acid level of l.Omg/dl or less wishes to join an athletics sports team (short track sprint) at school, a physician should instruct them to change to other activities. If a patient participates in a track event at an athletics meeting, a physician should instruct them to comply with the preventive methods described above. 

Ishikawa I (1981) Loin pain and acute renal failure after exercise at athletic meetings (in Japanese). Igaku-No-Ayumi (J Clin Exp Med) 119 920... 

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