Presentation
He has been the Editor in Chief, JAMA Neurology (1997- present) and a member of the Editorial Board of JAMA (1997-present). [books.google.com]
Genetic Clinical presentation Patients with genetic induced rhabdomyolysis will present with signs and symptoms of their inherited disease but will also present with secondary signs and symptoms of rhabdomyolysis. [physio-pedia.com]
Phenotype Varies in severity depending upon age of presentation and includes three main clinical presentations: 1) severe neonatal/early-childhood onset form presenting with cardiomyopathy, hepatic disease and hypotonia with high mortality in infancy, [ojrd.biomedcentral.com]
Get a quick and memorable overview of anatomy, pathophysiology, and clinical presentation from the precision and beauty of Netter and Netter-style plates that highlight key neuroanatomical and neurologic concepts. [books.google.de]
Entire Body System
- Pain
Site Pain: 3 people, 27.27% * Approximation only. [ehealthme.com]
Muscle pain usually in the skeletal muscles that are linked with body movement. In most cases, there is low back, shoulder and thigh muscle pain. [firstaidcprvictoria.ca]
No amount of rest and general pain treatment help in the muscle pain. The pain returns right after the affect of pain killers wear off. In initial stages of this disease, muscle ache is not experienced. [natural-homeremedies.com]
[…] a·cute re·cur·rent rhab·do·my·ol·y·sis [MIM*268200] repeated paroxysmal attacks of muscle pain and weakness followed by passage of dark red-brown urine, often precipitated by intercurrent illness and diagnosed by demonstration of myoglobin in the urine [medical-dictionary.thefreedictionary.com]
She did not have a urinary catheter, palpitations, dyspnea, back pain, abdominal pain, dysuria, or dizziness. Funding and Disclosures No potential conflict of interest relevant to this article was reported. [nejm.org]
- Weakness
Patients suffered generalized weakness, inability to walk, myalgia, muscle weakness, and dark urine. All patients appeared healthy in between episodes. [cags.org.ae]
[…] a·cute re·cur·rent rhab·do·my·ol·y·sis [MIM*268200] repeated paroxysmal attacks of muscle pain and weakness followed by passage of dark red-brown urine, often precipitated by intercurrent illness and diagnosed by demonstration of myoglobin in the urine [medical-dictionary.thefreedictionary.com]
[…] intoxication have also recently been implicated in the precipitation of the attacks. 16 The clinical picture of the disorder has been well described in several recent reviews. 3,5,21,35,37,44 The acute attacks are characterized by the rapid onset of muscular weakness [jamanetwork.com]
The muscle damage causes inflammation leading to tenderness, swelling, and weakness of the affected muscles. [medicinenet.com]
Symptoms of acute alcoholic myopathy may include muscle pain and swelling in addition to the classic weakness. [flipper.diff.org]
- Fever
[…] recurrent rhabdomyolysis has been suggested 5 as a diagnostic term for the syndrome of acute dissolution of striated muscle without known cause, but sometimes precipitated by physical exertion, restriction of carbohydrates in the diet, infections, or fever [jamanetwork.com]
Summary Rhabdomyolysis is a rare but potentially lethal complication of severe dengue fever. [casereports.bmj.com]
Mild rhabdomyolysis in a child with fever and "hematuria". Authors: Velibor Tasic University Children's Hospital Cleveland | United States Pediatr Nephrol 2003 May 28;18(5):462-4. Epub 2003 Mar 28. [pubfacts.com]
Fatigue Nausea and vomiting Weakness Seizures Joint pain Rapid heart rate Fever Tea-colored urine Muscle tenderness and stiffness Reduced urine output Remember that there is a possibility that none of these symptoms will manifest in all cases. [firstaidcprvictoria.ca]
Patients with crush syndrome have historically been described as presenting with muscle weakness, malaise, and fever. [physio-pedia.com]
- Asymptomatic
Stratifying risk of urinary tract malignant tumors in patients with asymptomatic microscopic hematuria. [citeseerx.ist.psu.edu]
After prolonged treatment it is possible to observe corneal microstores, normally asymptomatic which don t contraindicate the continuation of the therapy. [docplayer.net]
AF rather than paroxysmal AF according to the current definition of the guidelines.26 An important factor complicating this issue is that the physicians' perception of AF burden mostly underestimates the true AF burden, as many patients suffer from asymptomatic [slideplayer.it]
- Malaise
Patients with crush syndrome have historically been described as presenting with muscle weakness, malaise, and fever. [physio-pedia.com]
Constitutional symptoms vary on the cause; the most common are generalised malaise, fever and nausea. The associated electrolyte disturbance can lead to agitation and confusion. [patient.info]
Gastrointestinal
- Nausea
Fatigue Nausea and vomiting Weakness Seizures Joint pain Rapid heart rate Fever Tea-colored urine Muscle tenderness and stiffness Reduced urine output Remember that there is a possibility that none of these symptoms will manifest in all cases. [firstaidcprvictoria.ca]
Benadryl: 1 person, 9.09% Klonopin: 1 person, 9.09% Folic Acid: 1 person, 9.09% Elavil: 1 person, 9.09% Top symptoms for these people *: Weakness: 8 people, 72.73% Influenza Like Illness: 8 people, 72.73% Muscle Aches (muscle pain): 8 people, 72.73% Nausea [ehealthme.com]
Other Symptoms Fatigue, low urine production, confusion, arrhythmia, confusion, nausea, vomiting and low blood pressure are some of the other commonly reported symptoms of people suffering from Rhabdomyolysis. [natural-homeremedies.com]
Systemic signs and symptoms of rhabdomyolysis include tea-colored urine, fever, malaise, nausea, emesis, confusion, agaitation, delirium, and anuria. [physio-pedia.com]
Constitutional symptoms vary on the cause; the most common are generalised malaise, fever and nausea. The associated electrolyte disturbance can lead to agitation and confusion. [patient.info]
- Abdominal Pain
She did not have a urinary catheter, palpitations, dyspnea, back pain, abdominal pain, dysuria, or dizziness. Funding and Disclosures No potential conflict of interest relevant to this article was reported. [nejm.org]
This patient had several severe abdominal pain episodes which were misdiagnosed as appendicitis and he even underwent a futile laparotomy. Patients are pain free between the attacks. [usmleforum.com]
Swart JA, Vanic KA, Hauth JM, Stofanak JA, Primiano GA (2001) Abdominal pain and lower extremity cramping in an intercollegiate football player: a case report. J Athl Train 36(suppl):S-26 (abstract) Google Scholar 2. [link.springer.com]
Systemic symptoms such as malaise, fever, abdominal pain, and nausea and vomiting, may also be seen. [13] Metabolic and Electrolyte Disorders Rhabdomyolysis may be secondary to electrolyte abnormalities. [physio-pedia.com]
These symptoms were associated with generalized abdominal pain, nausea, vomiting, and shortness of breath at mild exertion. His past history included PNH since 2000 diagnosed by absent CD55 and CD59 assay by flow cytometry of red blood cells (RBCs). [karger.com]
- Diarrhea
Of the medical causes, sepsis (25%) and dehydration secondary to diarrhea and vomiting (21%) are the most common etiological factors of AKI which results in hemodialysis in 17% patients in each category. [karger.com]
Liver, Gall & Pancreas
- Jaundice
There was no history of fever, jaundice, petechial rash, hepatomegaly or bleeding, therefore clinical diagnoses of malaria, dengue fever, hepatitis or platelets disorder were less likely. [karger.com]
Musculoskeletal
- Myopathy
[…] of acute myopathy. [flipper.diff.org]
Recessive mutations in ANO5 (OMIM#608662) cause a wide spectrum of myopathies including LGMD2L, distal myopathy and isolated hyperCKemia. [ojrd.biomedcentral.com]
Part two then addresses the complete range of specific neuromuscular diseases: neuronopathies, peripheral neuropathies, neuromuscular junction disorders, muscle ion channel disorders, myopathies, and miscellaneous neuromuscular disorders and syndromes [books.google.com]
Myopathies such as dermatomyositis or myositis Viral or bacterial infections Metabolic conditions such as hypothyroidism and diabetic ketoacidosis [firstaidcprvictoria.ca]
[…] idiopathic) NEC - M62.82 Tabular List of Diseases and Injuries References found for the code M62.82 in the Tabular List of Diseases and Injuries: Type 1 Excludes Notes: traumatic rhabdomyolysis (T79.6) Information for Patients Muscle Disorders Also called: Myopathy [icdlist.com]
- Myalgia
Patients suffered generalized weakness, inability to walk, myalgia, muscle weakness, and dark urine. All patients appeared healthy in between episodes. [cags.org.ae]
RM and myalgia may be the dominating symptom in a few cases of LGMD2I [ 82 ]. [ojrd.biomedcentral.com]
Muscle aches and pain (myalgia), stiffness, and muscle weakness can occur with rhabdomyolysis, and is especially common with severe muscle damage. Rhabdomyolysis may cause a darkening of the urine color. [whereincity.com]
Muscle aches and pain ( myalgia ), stiffness, and muscle weakness can occur with rhabdomyolysis, and is especially common with severe muscle damage. Rhabdomyolysis may cause a darkening of the urine color. [medicinenet.com]
- Muscle Tenderness
Fatigue Nausea and vomiting Weakness Seizures Joint pain Rapid heart rate Fever Tea-colored urine Muscle tenderness and stiffness Reduced urine output Remember that there is a possibility that none of these symptoms will manifest in all cases. [firstaidcprvictoria.ca]
Haff disease typically presents as a paroxysm of rhabdomyolysis, with accompanying muscle tenderness, rigidity, and dark brown urine. However, as in patient 3, milder presentations also occur. [cdc.gov]
Physical examination of the lumbar region revealed paravertebral muscle tenderness bilaterally. Also during the second postoperative day, his abdomen became slightly distended, and oral intake was withheld because of the possibility of an ileus. [anesthesiology.pubs.asahq.org]
The three most common signs and symptoms are muscle pain, weakness, and dark urine. [2] [3] Muscle pain as well as weakness and tenderness may be general or specific to muscle groups. [physio-pedia.com]
Neurologic
- Headache
Following the acute episode, the husband complained of more frequent headaches, and his wife continued to experience tearing eyes, easy fatigability, and pruritus after eating seafood. Bakersfield, California Patient 6. [cdc.gov]
Dipyridamole may cause headache; the incidence of this may be reduced by increasing the dose gradually {Chang, 2006 #933;Diener, 2007 #945}. 1: Diener HC et al.: J Neurol Sci (1996) 143:1-13 2: Halkes P et al.: Lancet (2006) 367: Guidelines Ischaemic [slideplayer.it]
- Tingling
The swollen muscles exert pressure on the nerves and blood vessels whereas the myoglobin increases the impurity of the blood leading to erratic flow of blood and causes numbness and tingling sensation in those parts. [natural-homeremedies.com]
- Dizziness
She did not have a urinary catheter, palpitations, dyspnea, back pain, abdominal pain, dysuria, or dizziness. Funding and Disclosures No potential conflict of interest relevant to this article was reported. [nejm.org]
Urogenital
- Dark Urine
Patients suffered generalized weakness, inability to walk, myalgia, muscle weakness, and dark urine. All patients appeared healthy in between episodes. [cags.org.ae]
The dark urine color is due to myoglobin being excreted in the urine by the kidney as it tries to rid the body of the muscle breakdown products. [medicinenet.com]
Myoglobin is a dark-red, 17,8-kDa, monomeric heme protein that contains iron in its ferrous (Fe +2 ) form. [3] It is easily filtered by the glomerulus and is rapidly excreted into the urine. Plasma levels of myoglobin rapidly fall after its release. [emedicine.medscape.com]
The patient reported being in pain and that he had noticed dark colored urine 24 hours after his push up session. [physio-pedia.com]
Episodes of exercise-induced dark urine and myalgia in LGMD 2I. Acta Neurol Scand. 2012;125(4):285–7. PubMed Google Scholar Ceravolo F, Messina S, Rodolico C, Strisciuglio P, Concolino D. [ojrd.biomedcentral.com]
- Renal Injury
This fact provides evidence for a pathogenic role for free haemoglobin in tubulointerstitial renal injury in human PNH disease. [academic.oup.com]
References Zager RA: Studies of mechanisms and protective maneuvers in myoglobinuric acute renal injury. Lab Invest 1989;60:619-629. [karger.com]
It is believed that mannitol acts as a free-radical scavenger minimizing cell injury. Mannitol is also a renal vasodilator to prevent renal failure. [physio-pedia.com]
Workup
These differentials were kept in mind prior to ordering the workup. His laboratory data at admission are outlined in table 1. A previous renal function test was done in 2007 which showed 97.24 µmol/l serum creatinine and 4.99 mmol/l BUN. [karger.com]
Rhabdomyolysis: Differential Diagnoses and Workup. eMedicine 2009. ↑ Baxter R, Moore J. Diagnosis and Treatment of Acute Exertional Rhabdomyolysis. Journal of Orthopaedic and Sports Physical Therapy 2003; 33(3): 104-108 [physio-pedia.com]
Treatment
Part one discusses the approach to neuromuscular disorders, covering principles and basics, neuromuscular investigations, and assessment and treatment of neurological disorders. [books.google.com]
Treatment Mostly a urine test can reveal the presence of high protein level and thus confirm existence of Rhabdomyolysis. Under this section lets discuss various treatment options available. [natural-homeremedies.com]
Pharmacological treatment with amiodarone is indicated only after failure of electrical cardioversion. Many studies evaluated amiodarone for the treatment of hemodynamically unstable VT. [docplayer.net]
It is essential to seek medical treatment quickly, because if it is not treated it can result in kidney failure and muscle damage. The treatment is usually fluids and monitoring for changes in kidney function. [sharecare.com]
Current treatment of long-chain fat oxidation disorders. [jci.org]
Prognosis
Detailed discussions of PNH pathogenesis, management, and prognosis are presented separately. (See "Pathogenesis of paroxysmal nocturnal hemoglobinuria" and "Treatment and prognosis of paroxysmal nocturnal hemoglobinuria" .) [uptodate.com]
Rhabdomyolysis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Rhabdomyolysis from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and Prognosis [wikidoc.org]
Exactly measuring CA 19.9 concentrations >10,000 kU/L after multiple sample dilution does not add relevant information for patients’ prognosis and treatment. [sibioc.it]
What is the prognosis for rhabdomyolysis? The overall prognosis of rhabdomyolysis is favorable as long as it is recognized and treated promptly. Most causes of rhabdomyolysis reversible. [rxlist.com]
From What is the prognosis for rhabdomyolysis? The overall prognosis of rhabdomyolysis is favorable as long as it is recognized and treated promptly. Most causes of rhabdomyolysis reversible. [medicinenet.com]
Etiology
The etiology of the disorder is controversial. Proposed mechanisms include hyperparathyroidism, increased 1,25-dihydroxyvitamin D levels, and mobilization of calcium from soft-tissue deposits. [mdmag.com]
The first two etiologies were deemed most likely because of the abrupt nature and timing of his rhabdomyolysis. Moreover, the other etiologies occur rarely. [anesthesiology.pubs.asahq.org]
Evaluation of asymptomatic microscopic hematuria in adults: the American Urological Association best practice policy—part I: definition, detection, prevalence, and etiology. [citeseerx.ist.psu.edu]
Rhabdomyolysis: a review of clinical presentation, etiology, diagnosis, and management. Pediatr Emerg Care. 2008 Apr. 24(4):262-8. [Medline]. Lima RS, da Silva Junior GB, Liborio AB, Daher Ede F. Acute kidney injury due to rhabdomyolysis. [emedicine.medscape.com]
Although the etiology was not determined, epidemiologic investigations linked illness to ingestion of fish, especially burbot. The first reported case of Haff disease in the United States occurred in Texas in 1984 (M. [cdc.gov]
Epidemiology
Rhabdomyolysis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Rhabdomyolysis from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and [wikidoc.org]
EPIDEMIOLOGY PNH is a rare disorder. [uptodate.com]
Foodborne and Diarrheal Diseases Br, Div of Bacterial and Mycotic Diseases, National Center for Infectious Diseases; Div of Applied Public Health Training, Epidemiology Program Office; and an EIS Officer, CDC. [cdc.gov]
Epidemiology Incidence figures are not available for the general population, but screening of 337 military recruits for myoglobin serum levels, showed rhabdomyolysis in 40%. [ 6 ] It is more common in men, particularly well-educated professionals, who [patient.info]
He then did Masters in Science from the Department of Epidemiology at the Medical College of Wisconsin. [karger.com]
Pathophysiology
Get a quick and memorable overview of anatomy, pathophysiology, and clinical presentation from the precision and beauty of Netter and Netter-style plates that highlight key neuroanatomical and neurologic concepts. [books.google.de]
Rhabdomyolysis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Rhabdomyolysis from other Diseases Epidemiology and Demographics Risk Factors Natural History, Complications and [wikidoc.org]
The Gale Encyclopedia of Public Health states, 2002 - Alcoholic cardiomyopathy: incidence, clinical characteristics, and pathophysiology, Piano MR., 2002 SYMPTOMS Alcoholic myopathy can have serious symptoms and side effects. [flipper.diff.org]
The syndrome of rhabdomyolysis: Pathophysiology and diagnosis. Eur J Intern Med. 2007 Mar. 18(2):90-100. [Medline]. Kilfoyle D, Hutchinson D, Potter H, George P. [emedicine.medscape.com]
However, it may provide pathophysiologic clues to the molecular mechanism of kidney injury and the role of free haeme-containing molecules. [academic.oup.com]
Prevention
Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Rhabdomyolysis On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images American Roentgen Ray [wikidoc.org]
The authors describe two cases and suggest plans for the prevention and management of attacks. [ncbi.nlm.nih.gov]
Summary Rhabdomyolysis is found among people with Paroxysmal nocturnal haemoglobinuria, especially for people who are male, 60+ old, take medication Soliris and have Preventive health care. [ehealthme.com]
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.de]
Prevention is obviously the best way to limit the serious outcomes of this condition. Hydrating well, before, during and after the workout is one way to lower your risk. [healthcentral.com]