Rhabdomyolysis is a serious medical condition in which the muscle fibers breakdown. This action causes the release of a protein pigment called myoglobin into the blood stream. Myoglobin breaks down into compounds that are harmful to the kidneys. Early treatment and diagnosis of this potentially life-threatening condition improves the outcome and decreases the risk of serious, temporary and permanent complications.
Risk Factors
Rhabdomyolysis risk factors include heat intolerance or heatstroke, low phosphate levels, seizures and shaking chills. This condition also occurs because of crushing injuries, trauma to the muscles and overexertion of the muscles. Other risk factors for developing rhabdomyolysis include decreased blood flow to the muscles and death of the muscle tissue caused by arterial occlusion or deep vein thrombosis (DVT). Medications and substances that may cause this condition include alcohol, cocaine, amphetamines, ecstasy, LSD, PCP, heroin, corticosteroids, statins, Retrovir, colchicines, erythromycin, Sporanox and Sandimmune.
Symptoms
Symptoms of rhabdomyolysis include weakness, swelling, bruising, fever, nausea, vomiting, confusion, agitation, delirium, muscle stiffness or aching and tenderness of the muscles. This condition may also cause dark, red or tea-colored urine. Other symptoms of rhabdomyolysis include joint pain, fatigue, seizures and unplanned weight gain. If you experience these symptoms and are at risk for rhabdomyolysis, contact your physician or, if the symptoms are severe, seek emergency medical attention.
Complications
Early complications of rhabdomyolysis include high blood potassium levels, low blood calcium levels, liver inflammation, irregular heart rhythms and a heart attack. Late complications of rhabdomyolysis that can occur 12 to 24 hours after the onset of this condition include sudden kidney failure and disseminated intravascular coagulation. Kidney failure can cause fluid and wastes to buildup in the body. Disseminated intravascular coagulation is a clotting disorder that can lead to serious bleeding. Another complication of this condition is compartment syndrome, which can cause permanent muscle damage or death. Compartment syndrome a medical condition that causes nerve and blood vessel compression.
Diagnosis
A diagnosis of rhabdomyolysis begins with a physical examination to determine risk factors and the presence of symptoms. Your physician may order certain laboratory tests, including a creatine phosphokinase (CPK) which may indicate muscle damage, myoglobin blood test, a potassium blood test and a urine analysis, which is used to detect the presence of myoglobin.
Treatment
Treatment of rhabdomyolysis includes aggressive administration of IV fluids, treatment of complications and the use of medications, such as diuretics and bicarbonate. Other treatments include hemodialysis to treat kidney damage. In people without prior kidney damage, hemodialysis may recover kidney function over time. Not all treatments will be indicated for every person. To prevent rhabdomyolysis, drink plenty of fluids after engaging in strenuous activity or if you experience muscle damage.
