Rhabdomyolysis

Rhabdomyolysis is the breakdown of striated muscle or voluntary muscle cells (as opposed to nonstriated or smooth muscles which perform tasks on their own - the heart, for example). Rhabdomyolysis most commonly occurs in men.

Causes

Several factors may be responsible for causing rhabdomyolysis:

• arterial limb embolism (blood clot blocking an artery)
• drug or alcohol abuse
• hypothermia
• infection (influenza, malaria, salmonellosis, HIV, etc.)
• severe and strenuous physical exertion
• side effect of certain medications (statins, corticosteoids)
• symptoms associated with a chronic disease (ex. polymyositis)
• trauma

Symptoms

Symptoms primarily affect the muscles. Muscle pain and tenderness, stiffness, swelling, cramping and weakness can occur. Urine may also take on a reddish-brown colour.

Complications

Damaged cells release various muscle enzymes including myoglobin and potassium, two components that can be very damaging. In fact, an excess of potassium in the blood can lead to cardiac problems including cardiac arrest.

For its part, myoglobin causes kidney problems. The kidneys are responsible for filtering blood that is loaded with myoglobin. Myoglobin can severely damage the kidneys and lead to kidney failure.

Diagnosis

Rhabdomyolysis is diagnosed through blood tests. It is difficult for the physician to establish a diagnosis based solely on a description of symptoms.

Treatment

Hydration is crucial. Those with rhabdomyolysis must take in vast quantities of water in an effort to eliminate cell waste without damaging the kidneys. Hospitalization may be recommended for administration of intravenous fluids to optimize hydration.

If the renal failure is severe, dialysis may be required. Dialysis involves purifying the blood through a filtration system to prevent intoxication by toxins present in the blood that are generally eliminated by the kidneys.