End result of any disease process that causes muscle cell (myocyte) lysis.
May have an obvious presentation, such as traumatic 'crush' injury, or may be insidious, requiring a high clinical index of suspicion.
Muscular pain or discomfort is common, but rhabdomyolysis can have no symptoms or physical signs.
Diagnosis is confirmed by elevated serum creatine kinase level.
Fluid hydration is the mainstay of therapy.
Rhabdomyolysis may result from any traumatic or medical injury to the sarcolemma (the myocyte cell membrane) of the skeletal muscle cells. The subsequent release of intracellular ions, myoglobin, creatine kinase (CK), and urates into the circulation results in electrolyte disturbances, acidaemia, disseminated intravascular coagulation, renal failure, and multi-organ failure. The measurement of serum CK levels at more than 5 times the upper limit of normal is used as diagnostic criterion.
History and exam
Chinmay Patel, MD, FASN
Clinical Professor of Nephrology
University of Pikeville
Kentucky College of Osteopathic Medicine
Pikeville Medical Center
CP is an author of one reference cited in this topic.
Aditya Kadiyala, MD, MPH
Department of Medicine
Division of Nephrology
University of Maryland
Charles Regional Medical Center
AK declares that he has no competing interests.
Dr Chinmay Patel and Dr Aditya Kadiyala would like to gratefully acknowledge Dr Mark Shapiro, Dr Courtney Sommer, and Dr Robert D. Mathis, previous contributors to this topic.
MS is an author of references cited in this topic. CS and RDM declare that they have no competing interests.
Timothy Albertson, MD, PhD, MPH
Division of Pulmonary and Critical Care Medicine
University of California, Davis
TA declares that he has no competing interests.
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