Rhabdomyolysis and acute renal failure in a case of child abuse

The most common manifestations of child abuse are skin lesions, such as ecchymoses, abrasions, scars and burns. Bone fractures, failure to thrive, subdural and retinal hemorrhage, genital injuries, subgaleal hematoma, unkempt appearance, frozen stares, human bite marks, visceral injuries, etc., are additional manifestations. Munchausen syndrome by proxy is a rare presentation which has recently been well described in the literature. Various unusual manifestations of child abuse, such as fetal pepper aspiration, thirsting and hypernatremic dehydration, intentional microwave burns, transection and pseudocyst of the pancreas, tin ear syndrome, subcutaneous fat necrosis, etc., have also been recognized recently. These unusual symptoms deceive clinicians and prevent early diagnosis, thus endangering the life of the victim. There are very few reports in the world literature on the association of child abuse and acute renal failure induced by rhabdomyolysis. To our knowledge, this is the first confirmed case of child abuse with acute renal failure due to rhabdomyolysis in Saudi Arabia.