“Rhabdomyolysis: Pathogenesis, Diagnosis, and Treatment” – Links With Excerpts

What follows are excerpts from Resource (1) below, Rhabdomyolysis Pathogenesis, Diagnosis, and Treatment:


Rhabdomyolysis is a complex medical condition
involving the rapid dissolution of damaged or injured skeletal muscle. . . . Rhabdomyolysis ranges from an asymptomatic illness with elevation in the CK level to a life-threatening condition associated with extreme elevations in CK, electrolyte imbalances, acute renal failure (ARF), and disseminated intravascular coagulation.1

Clinically, rhabdomyolysis is exhibited by a triad of
symptoms: myalgia, weakness, and myoglobinuria,
manifested as the classically described tea-colored
urine. However, this rigid depiction of symptoms can be misleading as the triad is only observed in <10% of patients, and >50% of patients do not complain ofmuscle pain or weakness, with the initial presenting symptom being discolored urine.2 An elevated CK level is the most sensitive laboratory test for evaluating an injury to muscle that has the potential to cause rhabdomyolysis (assuming no concurrent cardiac or brain injury).1 Attempts to correlate the elevation in CK level with the severity of muscle damage and/or renal failure have had mixed results, although significant muscle injury is likely at CK levels >5,000 IU/L.1,9 Treatment for rhabdomyolysis, at least initially, is mainly supportive, centering on the management of the ABCs (airway, breathing, circulation) and measures to preserve renal function, including vigorous


Theoretically, any form of muscle damage and, by
extension, any entity that leads to or causes muscle
damage, can initiate rhabdomyolysis. In adults, the
available data show that the most common causes of
rhabdomyolysis are drug or alcohol abuse, medicinal drug use, trauma, NMS, and  immobility.18

The data in the pediatric population skew toward different leading causes, suggesting that viral myositis, trauma, connective tissue disorders, exercise, and drug overdose are responsible for much of the rhabdomyolysis seen in these patients; viral myositis alone may account for up to one-third of pediatric cases of rhabdomyolysis.14,15,19

While not a comprehensive list, many of the causes of rhabdomyolysis, both physical and nonphysical, are listed in Table 2. Table 3 lists drugs and other agents that can cause rhabdomyolysis. A few of
the frequent causes are explored in more depth [in the article].


Start here


(1) Rhabdomyolysis: Pathogenesis, Diagnosis, and Treatment [Pubmed Abstract] [Full Text HTML] [Full Text PDF]. Ochsner J. 2015 Spring;15(1):58-69.

The above article has been cited by 19 PubMed Central articles.

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