Schizoaffective Disorder and Concurrent Rhabdomyolysis

Thomas Varkey; Christopher Demetriades; Natalie Malluru; Zachary I Merhavy; Kyle Simtion; Caitlyn Garmer; Colton Zeitler; Raaj Pyada; Anne M Nguyen; Jack B Ding

doi:10.7759/cureus.19896

Schizoaffective Disorder and Concurrent Rhabdomyolysis

Cureus. 2021 Nov 25;13(11):e19896. doi: 10.7759/cureus.19896. eCollection 2021 Nov.

Authors

Thomas Varkey^{1

2}, Christopher Demetriades³, Natalie Malluru⁴, Zachary I Merhavy⁵, Kyle Simtion⁶, Caitlyn Garmer⁶, Colton Zeitler⁷, Raaj Pyada⁴, Anne M Nguyen⁴, Jack B Ding^{8

9}

Affiliations

¹ Colangelo College of Business, Grand Canyon University, Phoenix, USA.
² Department of Neurology, Dell Seton Medical Center, Austin, USA.
³ Department of Psychology, Dell Medical School, The University of Texas at Austin, Austin, USA.
⁴ Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, USA.
⁵ Department of Internal Medicine, Ross University School of Medicine, Bridgetown, BRB.
⁶ Department of Internal Medicine, Lincoln Memorial University, DeBusk College of Osteopathic Medicine, Harrogate, USA.
⁷ Department of Internal Medicine, Arizona College of Osteopathic Medicine, Midwestern University, Glendale, USA.
⁸ Department of Internal Medicine, The University of Adelaide, Adelaide, AUS.
⁹ Department of Internal Medicine, Royal Adelaide Hospital, Adelaide, AUS.

Abstract

The authors present a unique case of schizoaffective disorder exacerbation, complicated by substance misuse, rhabdomyolysis, and acute renal injury. The patient had been recently released from jail and was not on any psychiatric medications aside. His family reported bizarre behavior involving the patient spending a significant amount of time in an outdoor hot tub exposed to extreme heat, which the patient justified as necessary to protect him from snakes. The patient was diagnosed with severe dehydration and rhabdomyolysis, both of which were managed by the primary care team in a hospital setting with specialist input from the psychiatry and renal departments. The patient exhibited paranoid ideations toward the medical team and at times was agitated and combative. Resolution of this distrust was pivotal to successful treatment and was made possible through trilateral communication between the patient, the police officers, and medical staff.

Keywords: concurrent disorders; interprofessional care; law enforcement; non-traumatic rhabdomyolysis; schizoaffective disorder.

Publication types

Case Reports