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- In this condition, the destruction of muscle cells releases myoglobin and Potassium into the blood stream, causing damage to the kidneys and possible renal (kidney) failure.
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- May have no symptoms
- Muscle pain and tenderness
- Muscle swelling, Bruising
- Weakness
- Urine may be Coca-Cola colored (due to myoglobin)
- There may be joint pain
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- Trauma to the skeletal muscles, such as falls, auto accidents, and burns; seizures; prolonged bed rest; physical assault; head injury; prolonged bed rest; body building; and military exercise training
- Infections -- virus (Measles, Herpes, HIV, varicella, etc.), bacteria, parasites
- Disorders and diseases:
- Genetic or inherited diseases in which the gene for making a particular enzyme or chemical may be missing or abnormal (i.e., central core disease or acetyl-CoA dehdrogenase deficiencies, Sj?ren's syndrome, cytochrome b deficiency, glycogen storage diseases like McArdle's)
- Diabetes ketoacidosis
- Myopathies (muscle disorders) -- Polymyositis or dermatomyoitis
- Hypokalemia, Hypophosphatemia
- Hyperthermia or heat injury (stroke)
- Toxins or drugs (often by causing other conditions, i.e., seizures, Coma, Neuroleptic malignant syndrome, Potassium excretion, Renal tubules damage or direct muscle damage):
- Barbiturates.
- Amphetamine.
- Ethanol (Alcohol).
- Ecstasy.
- LSD.
- Cocaine.
- Heroin.
- Snake venom -- Cobra, Viper, rattlesnake
- Insect venom -- Wasps, African bee, brown recluse spider
- Carbon monoxide
- Metaldehyde
- Theophyline
- Haloperidol
- Rohypnol
- Lithium
- Salycilates
- Thiazide diuretics
- Toluene
- Amphotericin
- Clofibrate and other lipid-lowering drugs
- Thyroid hormone
- Many others
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History of symptoms, injury, illnesses, family history, surgeries, habits, medications, drugs, travels, occupation
- Medical exam may reveal tender muscles.
- Tests:
- Low urine amount or volume due to kidney or renal injury from Rhabdomyolysis
- Urine color is red or Coca-cola colored.
- Urine dip stick test may show presence of myoglobin pigment from the damaged muscle fibers, hemoglobin from damaged red blood cells, red blood cells, and clusters of pigment (casts).
- Blood tests will show elevation of muscle enzymes (normal muscle chemicals that are released after muscle damage) such as Creatinine kinase, aldolase, and lactic dehydrogenase; worsening renal functions (elevated BUN and Creatinine); increased Potassium, Phosphorus, Uric acid levels.
- Blood levels of Calcium are low (hypocalcemia) in the first stages of Rhabdomyolysis and during resultant kidney damage (acute tubular necrosis), but increase during recovery period.
- Electrocardiogram --
measures electrical activities of the heart -- is done, since increased Potassium levels (hyperkalemia) may cause dangerous heart rhythm irregularities.
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- Nursing home patients
- Alcoholics
- Post-surgery
- Drug abuse
- Any age -- seen in infants with genetic abnormalities
- Males > females
- See causes
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- Inpatient treatment in the hospital is necessary.
- Aim is to prevent renal or kidney failure.
- Intravenous or IV (in to the veins) fluids help flush and clear the kidneys of damaging muscle pigments and chemicals.
- Mannitol and Lasix are diuretics that by increasing urination help to further flush the kidneys. They are given IV.
- Decreasing the urine's acidity with Sodium Bicarbonate may also aid in flushing the kidneys.
- Treatment of hyperkalemia (using Insulin, glucose, Kayexalate) and Hypocalcemia (Vitamin D and Calcium gluconate) is necessary.
- In some cases of kidney failure, kidney dialysis must be done using a machine that filters and clears the blood of body toxins until the kidneys recover and can perform their normal function of removing bodily waste and toxins.
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