Rhabdomyolysis following diphenhydramine overdose-a case report.

Abstract

Antihistamines, such as diphenhydramine, are active ingredients of a wide variety of antiallergics, sedatives, and sleep preparations and are often abused for purposes of euphoric effects or suicidal attempts. Antihistaminic overdose presents with symptoms of increased anticholinergic activity including urinary retention, mydriasis, and dry mucous membranes. However, antihistamine-induced rhabdomyolysis is a rare condition that presents with widespread skeletal muscle breakdown and release of metabolites into the circulation, resulting in myalgias and acute kidney injury. In this article, we report a rare case of rhabdomyolysis following the ingestion of a large quantity of diphenhydramine for a suicide attempt, who also presented with significantly elevated creatine kinase and acute renal injury. To our knowledge, this is the first case report of diphenhydramine rhabdomyolysis with MRI findings' correlation.