Diagnostic evaluation of rhabdomyolysis

Jessica Nance, Andrew L. Mammen

Research output: Contribution to journalArticle

Abstract

Rhabdomyolysis is characterized by severe acute muscle injury resulting in muscle pain, weakness, and/or swelling with release of myofiber contents into the bloodstream. Symptoms develop over hours to days after an inciting factor and may be associated with dark pigmentation of the urine. Serum creatine kinase and urine myoglobin levels are markedly elevated. Clinical examination, history, laboratory studies, muscle biopsy, and genetic testing are useful tools for diagnosis of rhabdomyolysis, and they can help differentiate acquired from inherited causes of rhabdomyolysis. Acquired causes include substance abuse, medication or toxic exposures, electrolyte abnormalities, endocrine disturbances, and autoimmune myopathies. Inherited predisposition to rhabdomyolysis can occur with disorders of glycogen metabolism, fatty acid β-oxidation, and mitochondrial oxidative phosphorylation. Less common inherited causes of rhabdomyolysis include structural myopathies, channelopathies, and sickle-cell disease. This review focuses on the differentiation of acquired and inherited causes of rhabdomyolysis and proposes a practical diagnostic algorithm.

Original languageEnglish (US)
Pages (from-to)793-810
Number of pages18
JournalMuscle and Nerve
Volume51
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Rhabdomyolysis
Muscular Diseases
Urine
Channelopathies
Muscles
Myoglobin
Poisons
Myalgia
Oxidative Phosphorylation
Muscle Weakness
Pigmentation
Genetic Testing
Sickle Cell Anemia
Creatine Kinase
Glycogen
Electrolytes
Substance-Related Disorders
Fatty Acids
History
Biopsy

Keywords

  • Etiology
  • Inherited myopathy
  • Metabolic myopathy
  • Rhabdomyolysis
  • Symptoms

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)
  • Physiology

Cite this

Diagnostic evaluation of rhabdomyolysis. / Nance, Jessica; Mammen, Andrew L.

In: Muscle and Nerve, Vol. 51, No. 6, 01.06.2015, p. 793-810.

Research output: Contribution to journalArticle

Nance, Jessica ; Mammen, Andrew L. / Diagnostic evaluation of rhabdomyolysis. In: Muscle and Nerve. 2015 ; Vol. 51, No. 6. pp. 793-810.
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