Cannabinoids-Induced Rhabdomyolysis in a Patient: A Report of a Case and a Review of Literature.

Rhabdomyolysis is a life-threatening complication and is sometimes, though rarely, induced by the use of synthetic cannabinoids. The pathophysiology is poorly understood. However, the effect is through the activation of G-protein coupled receptors. We discuss the case of a 48-year-old man who was a known case of muscle-invasive bladder cancer and received four cycles of neoadjuvant chemotherapy. An X-ray showed an interval decrease in urinary bladder wall size and pelvic lymph nodes. He underwent radical cystoprostatectomy with lymph node dissection and an orthotopic new bladder. Postoperatively, the patient developed severe back pain, reduced lower limb function, and shortness of breath. Laboratory investigations revealed elevated creatinine and creatine kinase levels and decreased urine output. The diagnosis of rhabdomyolysis was made. Accordingly, the patient required continuous renal replacement therapy and was then shifted to hemodialysis. There are limited data available mentioning the effect of synthetic cannabinoids in the development of rhabdomyolysis. Our study emphasizes the importance of understanding the effects of synthetic cannabinoid toxicity in the development of rhabdomyolysis as well as of educating physicians and pharmacists in establishing better therapeutic and protective measures for satisfactory outcomes and minimizing the risk of mortality if left untreated.