Rhabdomyolysis

Rhabdomyolysis is the 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, acute kidney injury (AKI), and multi-organ failure. The measurement of serum CK levels at more than 5 times the upper limit of normal or >1000 IU/L is used as a diagnostic criterion.[1]Poels PJ, Gabreels FJ. Rhabdomyolysis: a review of the literature. Clin Neuro Neurosurg. 1993 Sep;95(3):175-92. http://www.ncbi.nlm.nih.gov/pubmed/8242960?tool=bestpractice.com [2]Kodadek L, Carmichael Ii SP, Seshadri A, et al. Rhabdomyolysis: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document. Trauma Surg Acute Care Open. 2022;7(1):e000836. https://tsaco.bmj.com/content/7/1/e000836 http://www.ncbi.nlm.nih.gov/pubmed/35136842?tool=bestpractice.com