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May 27, 1974

Myoglobinuria Following Lightning Stroke

Author Affiliations

From the Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kan.

JAMA. 1974;228(9):1147-1148. doi:10.1001/jama.1974.03230340049033

PHYSICIANS should be alerted to two facets of lightning injury: first, that it may be accompanied by myoglobinuria that has clearly been shown to precipitate acute tubular necrosis and renal failure in some individuals, and second, that the resuscitation of individuals "killed" by lightning, as previously emphasized by Jex-Blake1 and Taussig,2 is eminently successful, with almost complete recovery.

Report of a Case  A 14-year-old teen-ager was struck on the right shoulder by a bolt of lightning. He was successfully resuscitated by defibrillation 15 minutes later. When first seen at the Kansas University Medical Center (KUMC) 2 1/2 hours after the incident, the patient was actively moving all four extremities, rolling his eyes, but was unresponsive to vocal and other sensory stimuli. Results of physical examination showed feathery flaring burns and singed hair that extended from the right shoulder to both ankles (Fig 1 and 2). In addition, the patient's right