Rhabdomyolysis (severe muscle breakdown)


General or Other | Orthopaedics | Rhabdomyolysis (severe muscle breakdown) (Disease)


Description

Rhabdomyolysis is a condition in which damaged skeletal muscle tissue breaks down rapidly. Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure.

Causes and Risk factors

Some common causes of the muscle damage due to rhabdomyolysis include: major blunt trauma and crush injury, electrocution, lightening strike, major burns, prolonged immobilization (for example, patients who have been lying in one position for a prolonged period of time due to a debilitating stroke, alcohol or drug overdose, or those who have remained unconscious for a prolonged period of time for other reasons), excessive exercise, for example, running a marathon or excessive weight lifting, patients in status epilepticus, in which the seizure lasts for a prolonged period of time and muscles involuntarily contract, dystonic reactions cause muscles to spasm, and if left untreated can damage muscle, cholesterol lowering medications [for example, statins prescribed to treat high cholesterol (particularly when combined with other cholesterol lowering medications such as fibrates).

Diagnosis and Treatment

Treatment is intended to treat the patients shock, and preserve kidney function. Typically, saline IV fluids are generously provided. Between 6 to 12 liters over a 24-hour period is the recommended range. Electrolyte levels are usually abnormal in the early stages of rhabdomyolysis. Also, calcium levels tend to be low initially. However, as the patient improves, calcium is released in the patient, and hypercalcemia may occur.

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