000			03164nam a22003857a 4500
008			221213s20222022 xxu||||| |||| 00| 0 eng d
022			_a2376-0605
024			_a10.1016/j.aace.2022.09.005 [doi]
024			_aPMC9701813 [pmc]
024			_aS2376-0605(22)00064-5 [pii]
040			_aOvid MEDLINE(R)
099			_a36447833
245			_aLocalized Rhabdomyolysis Associated With Testosterone Enanthate for Gender-Affirming Hormonal Therapy.
251			_aAace Clinical Case Reports. 8(6):264-266, 2022 Nov-Dec.
252			_aAACE clin. case rep.. 8(6):264-266, 2022 Nov-Dec.
253			_aAACE clinical case reports
260			_c2022
260			_fFY2023
260			_p2022 Nov-Dec
265			_sepublish
266			_d2022-12-13
520			_aBackground/Objective: Rhabdomyolysis is a condition characterized by the destruction of skeletal muscle tissue that leads to systemic complications. We present a case of gender-affirming intramuscular (IM) testosterone therapy precipitating localized deltoid rhabdomyolysis.
520			_aCase Report: A 34-year-old transgender man presented to the emergency department with dark-colored urine and pain in the left deltoid muscle where he had been injecting IM testosterone. He was found to have significant elevation in the level of creatinine kinase that was consistent with rhabdomyolysis and managed with intravenous fluids. He received trial therapy with IM testosterone again in the contralateral deltoid twice with recurrent rhabdomyolysis. He eventually transitioned to subcutaneous testosterone to achieve his masculinization goals without adverse effects.
520			_aConclusion: This case report highlights the potential risk of rhabdomyolysis associated with IM testosterone administration in the deltoid region for gender-affirming care. Patients on IM testosterone should use the thigh or gluteal muscles rather than the deltoid. Copyright © 2022 AACE. Published by Elsevier Inc.
520			_aDiscussion: Localized anabolic steroid use has been associated with rhabdomyolysis. However, to the best of our knowledge, this is the first case report of rhabdomyolysis attributed to gender-affirming testosterone therapy. Our patient had been administering testosterone intramuscularly into larger muscles (thigh and gluteus) for many years without any issues, whereas recurrent focal rhabdomyolysis developed only in association with deltoid injections. We theorize that a relative increase in dose and volume of testosterone per gram of muscle after switching to the deltoid site precipitated rhabdomyolysis. Subcutaneous testosterone is an acceptable alternative to IM testosterone for patients desiring an injectable delivery route with minimal adverse effects.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Franklin Square Medical Center
656			_aEndocrinology
657			_aCase Reports
700			_aLizama-Hernandez, SergioW _bMFSMC
790			_aLizama-Hernandez S, Port AM, Reddy R
856			_uhttps://dx.doi.org/10.1016/j.aace.2022.09.005 _zhttps://dx.doi.org/10.1016/j.aace.2022.09.005
942			_cART _dArticle
999			_c117 _d117