Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream.
Causes of Rhabdomyolysis
A crush injury such as from an auto accident, fall, or building collapse
Long-lasting muscle compression such as that caused by prolonged immobilization after a fall or lying unconscious on a hard surface during illness or while under the influence of alcohol or medication
Electrical shock injury, lightning strike, or third-degree burn
Venom from a snake or insect bite
The use of alcohol or illegal drugs such as heroin, cocaine or amphetamines
Extreme muscle strain, especially in someone who is an untrained athlete; this can happen in elite athletes, too, and it can be more dangerous if there is more muscle mass to break down.
The use of medications such as antipsychotics or statins, especially when given in high doses
A very high body temperature (hyperthermia) or heat stroke
Seizures or delirium tremens
A metabolic disorder such as diabetic ketoacidosis
Diseases of the muscles (myopathy) such as congenital muscle enzyme deficiency or Duchenne’s muscular dystrophy
Viral infections such as the flu, HIV, or herpes simplex virus
Symptoms of Rhabdomyolysis
classic triad of rhabdomyolysis symptoms are: muscle pain in the shoulders, thighs, or lower back; muscle weakness or trouble moving arms and legs; and dark red or brown urine or decreased urination. Keep in mind that half of people with the condition may have no muscle-related symptoms.
Other common signs of rhabdomyolysis include:
Nausea or vomiting
Fever, rapid heart rate
Confusion, dehydration, fever, or lack of consciousness
Diagnosis of Rhabdomyolysis
Blood tests for creatine kinase, a product of muscle breakdown, and urine tests for myoglobin, a relative of hemoglobin that is released from damaged muscles, can help diagnose rhabdomyolysis (although in half of people with the condition, the myoglobin test may come up negative).
Other tests may rule out other problems, confirm the cause of rhabdomyolysis, or check for complications.
Treatment of Rhabdomyolysis
If you have rhabdomyolysis, you will be admitted to the hospital to receive treatment for the cause.
Treatment with intravenous (IV) fluids helps maintain urine production and prevent kidney failure.
Rarely, dialysis treatment may be needed to help your kidneys filter waste products while they are recovering.
Management of electrolyte abnormalities (potassium, calcium and phosphorus) helps protect your heart and other organs.
You may also need a surgical procedure (fasciotomy) to relieve tension or pressure and loss of circulation if compartment syndrome threatens muscle death or nerve damage.
In some cases, you may need to be in the intensive care unit (ICU) to allow close monitoring.
Most causes of rhabdomyolysis are reversible.
If rhabdomyolysis is related to a medical condition, such as diabetes or a thyroid disorder, appropriate treatment for the medical condition will be needed.
And if rhabdomyolysis is related to a medication or drug, its use will need to be stopped or replaced with an alternative.