Rhabdomyolysis is a group of symptoms that occurs after muscle damage. Rhabdomyolysis may occur, inter alia, in people taking certain medications - especially statins, and also after intense exercise, e.g. after a marathon. If untreated, muscle breakdown can even lead to kidney failure. What are the causes and symptoms of rhabdomyolysis? What is the treatment?

Rhabdomyolysis( muscle breakdown ) is a group of symptoms caused by damage to the striated muscles. As a result of the damage, components of muscle cells - including myoglobins, enzymes and other substances potentially toxic to various organs - enter the bloodstream. As a consequence, many serious complications can occur, the most serious of which is kidney damage.

Rhabdomyolysis - causes

  • acute myopathies (muscle diseases)
  • external mechanical damage (e.g. in victims of car accidents)
  • external thermal damage (e.g. extensive burns)
  • extreme physical exertion - post-exercise rhabdomyolysis usually occurs in athletes (e.g. marathon runners) and people undergoing intense training (soldiers, bodybuilders), although it can also occur in people who start sharp training (e.g. gym) after a break, in beginner bodybuilders or people undertaking intense exercise, e.g. after viral infections
  • acute ischemia of large muscle groups (e.g. in cases of major surgery)
  • taking medications (statins, fibrates, salicylates)
  • alcohol poisoning or carbon monoxide poisoning
  • status epilepticus or frequent seizures on a different basis
  • electric shock
  • some viral and bacterial infections - mainly in the course of sepsis
  • electrolyte disturbances, especially hypokalemia (potassium deficiency) and hypophosphatemia (phosphorus deficiency)
  • venom of some snakes

Rhabdomyolysis - symptoms

  • muscle weakness

Characteristic for rhabdomyolysis is brown urine, resembling weak coffee

  • muscle swelling
  • gentle increase in muscle tone
  • muscle cramp
  • muscle pain(myalgia) at rest - most often in the lumbar region and in the proximal (initial) parts of the limbs

Muscle symptoms are often accompanied by fever and para-influenza symptoms. In addition, increased muscle damage may cause convulsions and disturbances of consciousness.

Important

Rhabdomyolysis - serious complications

When muscle cells break down, potentially toxic substances are released into the bloodstream. As a consequence, serious complications may occur - hyperkalemia, arrhythmias or the appearance of features of disseminated intravascular coagulation (DIC). However, the most serious complication of rebdomyolysis is acute renal failure.

During muscle damage, myoglobin is released from muscle cells, which is properly filtered in the kidney glomeruli, passing into the renal tubules. However, the renal tubules are unable to filter and excrete them when myoglobin is overabundant. Then the excess of myoglobin forms conglomerates in the renal tubules, leading to their narrowing and necrosis.

Additionally, it causes constriction of the kidney vessels and has a local toxic effect. The consequence of this process is renal failure. It is estimated that in the event of improper treatment, it occurs in 40 percent. sick.

Rhabdomyolysis - diagnosis

If rhabdiomyolysis is suspected, a number of blood tests are performed. At that time, an increased level of muscle enzymes is observed - CK, i.e. creatine kinase (over 10,000 U / L), AST, i.e. aspartate aminotransferase and LDH, i.e. lactate dehydrogenase, as well as an increase in urea and creatinine levels.

Rhabdomyolysis - treatment

Treatment depends on the cause. For example, if medications are responsible for the breakdown of muscles, they should be stopped. In addition, fluids are administered parenterally (however, in the development of renal failure, it is contraindicated) and mannitol, which increases blood flow through the kidneys and reduces interstitial swelling in the area of ​​damaged tissues.

In some severe cases of rhabdomyolysis, renal replacement therapy, i.e. dialysis, is necessary.

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Spine, bones, joints