Rhabdomyolysis is a serious syndrome due to a direct or indirect muscle injury. It results from a breakdown of muscle fibers and release of their contents into the bloodstream. This can lead to complications such as kidney (renal) failure. This occurs when the kidneys cannot remove waste and concentrated urine. In rare cases, rhabdomyolysis can even cause death. However, prompt treatment often brings a good outcome. Here's what you need to know about rhabdomyolysis.
There are many causes of rhabdomyolysis. The most common causes include:
- The use of alcohol or illegal drugs such as cocaine or amphetamines
- Extreme muscle strain, especially in someone who is an untrained athlete. This can happen in elite athletes too, however. And it can be more dangerous if there is more muscle mass to break down.
- A crush injury such as from an auto accident, fall, or building collapse
- Long-lasting muscle compression such as that caused by lying unconscious on a hard surface during illness or while under the influence of alcohol or medication
- The use of drugs such as corticosteroids or statins, especially when given in high doses
Other rhabdomyolysis causes include:
- Electrical shock injury, lightning strike, or third-degree burn
- A very high body temperature (hyperthermia) or heat stroke
- A Metabolic disorder such as ketoacidosis
- Diseases of the muscles (myopathy) such as congenital muscle enzyme deficiency or Duchenne's muscular dystrophy
- Viral infections such as the flu, HIV, or herpes simplex virus
- Bacterial infections leading to toxins in tissues or the bloodstream (sepsis)
A previous history of rhabdomyolysis also increases the risk of having rhabodomyolysis once again.
Rhabdomyolysis Signs and Symptoms
Signs and symptoms of rhabdomyolysis may be hard to pinpoint. This is largely true because the course of rhabdomyolysis varies, depending on its cause. And, symptoms may occur in one area of the body or affect the whole body. Also, complications may occur in early and later stages.
The following are common signs and symptoms of rhabdomyolysis:
- Painful, swollen, bruised, or tender areas of the body
- Muscle weakness or trouble moving arms or legs
- General feelings of illness
- Nausea or vomiting
- Confusion, dehydration, fever, or lack of consciousness
- Dark-colored urine; reduced or no urine output
Blood and urine tests can help diagnose rhabdomyolysis. Other tests may rule out other problems, confirm the cause of rhabdomyolysis, or check for complications.
Early complications of rhabdomyolysis may include very high levels of potassium in the blood. This can lead to an irregular heartbeat or cardiac arrest. About one in four also develop problems with the liver. Later, rhabdomyolysis can also lead to kidney failure. This occurs in about 15% of patients. A condition called compartment syndrome may also occur either early or later. This serious compression of nerves, blood vessels, and muscles can cause tissue damage and problems with blood flow.