Rhabdomyolysis after ERCP in a patient with pancreatic adenocarcinoma: A paraneoplastic phenomenon?

Authors

• Roaa Aljunaidi, Faculty of Medicine, Palestine Polytechnic University, Wadi Al-Haria, Hebron, West Bank, P.O. Box 198, Palestine.
• Qutaiba Qafisheh, Department of Medicine, College of Medicine and Life Sciences, The University of Toledo, 3000 Arlington Avenue, Toledo, OH 43614-2598, United States.
• Abdalhakim Shubietah, Advocate Health - MidwestFollow
• Mohamed S. Elgendy, Faculty of Medicine, Tanta University, El-Gash St., Tanta, El-Gharbia Governorate 31527, Egypt.
• Muath A. Baniowda, Department of Medicine, School of Medicine, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108-2792, United States.
• Ahmed Emara, Faculty of Medicine, Al-Azhar University, 1 El Mokhayam El Daem St., Nasr City, Cairo 11884, Egypt.
• Mohanad Qwaider, Department of Medicine, College of Medicine and Life Sciences, The University of Toledo, 3000 Arlington Avenue, Toledo, OH 43614-2598, United States.
• Fadi Safi, Department of Medicine, College of Medicine and Life Sciences, The University of Toledo, 3000 Arlington Avenue, Toledo, OH 43614-2598, United States.

Recommended Citation

Aljunaidi R, Qafisheh Q, Shubietah A, et al. Rhabdomyolysis after ERCP in a patient with pancreatic adenocarcinoma: a paraneoplastic phenomenon?. Oxf Med Case Reports. 2026;2026(3):omag019. Published 2026 Mar 23. doi:10.1093/omcr/omag019

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background: Paraneoplastic myopathies are rare complications of malignancy, most often associated with lung, ovarian, and gastrointestinal cancers. Rhabdomyolysis as a paraneoplastic manifestation of pancreatic adenocarcinoma is exceedingly uncommon and typically portends a poor prognosis.

Case presentation: We describe an 80-year-old male with newly diagnosed pancreatic adenocarcinoma who developed fulminant rhabdomyolysis shortly after endoscopic ultrasound and ERCP with biliary stent placement. Laboratory studies showed CPK levels > 66 000 U/l and serum myoglobin > 40 000 ng/ml, leading to acute kidney injury and multiorgan failure despite aggressive fluid resuscitation, corticosteroids, CRRT, and broad-spectrum antibiotics. Autoimmune and paraneoplastic serologies were unrevealing. The patient died on hospital day five.

Conclusion: The rapid onset of rhabdomyolysis following ERCP raises the possibility that tumor manipulation or antigenic exposure may serve as an immune trigger for paraneoplastic muscle injury.

Type

Article

PubMed ID

41878595