Volume 6, Number 15;  July 20, 2006

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Unique Identifier [PMID]: 12920439

Authors: Allison RC. Bedsole DL.

Institution: Division of Pulmonary andCritical Care Medicine, Department of Internal Medicine, University of South Alabama College of Medicine, Medical Center, 2451 Fillingim Street, Suite 10-G, Mobile, AL 36617, USA. rallison@pol.net

Title: The other medical causes of rhabdomyolysis. [Review] [47 refs]

Source: American Journal of the Medical Sciences. 326(2):79-88, 2003 Aug.

Abstract: Rhabdomyolysis is the clinical and laboratory syndrome resulting from skeletal muscle injury and release of potentially toxic substances into the circulation. The severity of rhabdomyolysis varies widely from asymptomatic elevation of muscle enzymes to the life-threatening complications of acute renal failure and severe electrolyte abnormalities. The etiology of rhabdomyolysis may be considered under 4 categories: (1) trauma or direct injury, (2) excessive muscle activity, (3) hereditary muscle enzyme defects, and (4) other less obvious medical causes. The latter medical causes may be subdivided into the following: (1) drugs and toxins, (2) muscle hypoxia, (3) metabolic and endocrine disorders, (4) infections, (5) temperature alterations, and (6) miscellaneous causes. The diagnosis of rhabdomyolysis depends on recognizing the symptoms of muscle pain and weakness, detecting the presence of or history of red-to-brown urine (myoglobinuria), and finding short-term elevations of creatine kinase that are not attributable to myocardial infarction or inflammatory myopathies. The major therapeutic goal is to recognize and treat complications as soon as possible, particularly electrolyte abnormalities and acute renal failure. Knowledge of the other medical causes of rhabdomyolysis allows one to identify and treat this potentially serious condition in otherwise occult cases. [References: 47]

Publication Type: Journal Article. Review.

 Link Directly to Fulltext Article at Publisher

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Unique Identifier [PMID]: 11898964

Authors: Sauret JM. Marinides G. Wang GK.

Institution: Department of Family Medicine, State University of New York at Buffalo School of Medicine and Biomedical Sciences, 14215, USA. sauret@acsu.buffalo.edu

Title: Rhabdomyolysis. [Review] [29 refs]

Source: American Family Physician. 65(5):907-12, 2002 Mar 1.

Abstract: Rhabdomyolysis is a potentially life-threatening syndrome resulting from the breakdown of skeletal muscle fibers with leakage of muscle contents into the circulation. The most common causes are crush injury, overexertion, alcohol abuse and certain medicines and toxic substances. Several inherited genetic disorders, such as McArdle's disease and Duchenne's muscular dystrophy, are predisposing factors for the syndrome. Clinical features are often nonspecific, and tea-colored urine is usually the first clue to the presence of rhabdomyolysis. Screening may be performed with a urine dipstick in combination with urine microscopy. A positive urine myoglobin test provides supportive evidence. Multiple complications can occur and are classified as early or late. Early complications include severe hyperkalemia that causes cardiac arrhythmia and arrest. The most serious late complication is acute renal failure, which occurs in approximately 15 percent of patients with the syndrome. Early recognition of rhabdomyolysis and prompt management of complications are crucial to a successful outcome. [References: 29]

Publication Type: Journal Article. Review.

Link Directly to Fulltext Article at Publisher

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Unique Identifier [PMID]: 11870710

Authors: Warren JD. Blumbergs PC. Thompson PD.

Institution: Department of Neurology, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Title: Rhabdomyolysis: a review. [Review] [168 refs]

Source: Muscle & Nerve. 25(3):332-47, 2002 Mar.

Abstract: Rhabdomyolysis, a syndrome of skeletal muscle breakdown with leakage of muscle contents, is frequently accompanied by myoglobinuria, and if sufficiently severe, acute renal failure with potentially life-threatening metabolic derangements may ensue. A diverse spectrum of inherited and acquired disorders affecting muscle membranes, membrane ion channels, and muscle energy supply causes rhabdomyolysis. Common final pathophysiological mechanisms among these causes of rhabdomyolysis include an uncontrolled rise in free intracellular calcium and activation of calcium-dependent proteases, which lead to destruction of myofibrils and lysosomal digestion of muscle fiber contents. Recent advances in molecular genetics and muscle enzyme histochemistry may enable a specific metabolic diagnosis in many patients with idiopathic recurrent rhabdomyolysis. Copyright 2002 Wiley Periodicals, Inc. [References: 168]

Publication Type: Journal Article. Review.

Resident Report / Department of Medicine & Grady Branch Library

Emory University School of Medicine

2006 Edition

Participating Faculty:  Carlos Del Rio MD  / Joyce Doyle MD / Lorenzo Difrancesco MD / Joel Mermis MD / Maunank Shah MD

Contact: Karl Woodworth