Rhabdomyolysis: Symptoms, Causes and Treatment

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Rhabdomyolysis
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Rhabdomyolysis

• Rhabdomyolysis is a disorder that involves rapid
  breakdown of skeletal muscle, due to an injury.
  As a result the components of the skeletal muscle
  cells are released into the blood stream. These
  may include phosphate, potassium and myoglobin.
  The protein myoglobin is found in the urine.
  However, destruction of skeletal muscle can
  increase the myoglobin levels in the urine which
  can damage the kidneys. The skeletal muscle is a
  type of muscle in our body, and is made up of
  muscle fibres. It helps to move the skeleton at
  joints. The muscles of arms and legs contain
  skeletal muscle cells. The kidneys perform the
  functions of filtering the blood. But as the
  blood is overloaded with the by-products
  (myoglobin, potassium) of skeletal muscle
  breakdown, the kidneys may find it extremely
  difficult to perform its daily task. This can
  result to kidney failure.

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Causes of Rhabdomyolysis

• Rhabdomyolysis occurs with muscle injury. There
  are a number of factors responsible for causing
  injury to muscles. Metabolic syndrome such as
  ketoacidosis that are marked by excessive
  production of ketone bodies can also induce
  damage to the skeletal muscles. Other causes are
  given below Exercise Severe exercise or
  following a rigorous exercise program can
  disintegrate the skeletal muscle. Extreme muscle
  activity may injure the muscles. A prolong
  strenuous exercise such as running in marathons
  can be harmful to the skeletal muscles. Diseases
   Medical conditions such as severe asthma,
  seizures, severe hyperthyroidism or too much
  diarrhoea or vomiting can lead to
  rhabdomyolysis. 

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Causes of Rhabdomyolysis
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• Trauma Trauma such as a car accident, lightning
  strike or an electric shock can result into
  rhabdomyolysis. Alcoholism Consuming
  alcohol increases the urinary rate and dehydrates
  the body, in turn making the muscles weak.
  Moreover, it hinders protein production, crucial
  for muscle growth. If this was not enough,
  drinking alcohol can also impair synthesis of
  testosterone, a hormone that assists in building
  muscles. Thus, binge drinking on a daily basis is
  likely to severely damage the skeletal muscles
  and may even destroy the muscle mass. No wonder,
  alcoholics face an increased risk of suffering
  from rhabdomyolysis. Seizures As we all know,
  seizures are characterised by repetitive movement
  of skeletal muscles. In most cases, the duration
  of seizures vary from a few seconds to a minute
  or two.

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Causes of Rhabdomyolysis
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• However, if seizure activity continues for
  prolonged periods of time (more than 5 minutes),
  it can induce breakdown of skeletal muscles,
  eventually leading to rhabdomyolysis.Heatstroke
   Doing a physically taxing job for a considerable
  amount of time in the hot sun increases the body
  temperature above 104 degree Fahrenheit, a
  condition commonly referred to as heatstroke.
  Initially, a person affected with heatstroke
  experiences muscle cramps and headache but with
  no treatment and continued exposure to the sun
  the skeletal muscle fibre may rupture, causing
  rhabdomyolysis. Medicines Statins given
  to high cholesterol patients, may damage the
  muscles. Statin medications often cause muscle
  aching. Overdose of diuretics (water pills) or
  aspirin is harmful, as it causes an electrolyte
  imbalance.

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Causes of Rhabdomyolysis
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• Anti-cholesterol medicines, antidepressants or
  illegal drugs such as opiates, ecstasy and
  amphetamines may damage the muscles. Scientists
  believe that certain cholesterol lowering drugs
  such as crestor, clofibrate and gemfibrozil, may
  cause rhabdomyolysis. Crestor has also been
  linked to renal failure.

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Symptoms

• People having rhabdomyolysis  often experience
  pain, swelling and weakness in their arms, legs
  or lower back. Other symptoms associated with
  this disease are as follows 
• Dark-coloured urine (abnormal urine colour) blood
  is found in the urine
• Muscle tenderness Bruising of muscles
• Joint pain
• Fast heartbeats
• Nausea
• Unintentional weight gain
• Seizures
• Fatigue
• Over time, rhabdomyolysis can harm the lungs,
  leading to breathing problems. Swollen hands and
  feet point towards fluid retention, which may be
  due to kidney failure.

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Treatments

• Once the doctor diagnoses the condition, rapid
  treatment is a must to get a positive outcome. An
  easy way to prevent life-threatening
  complications from skeletal muscle
  disintegration is to practice generous hydration
  as early as possible. Patients are treated with
  intravenous hydration, where fluids are
  administered directly into the blood vessels via
  a catheter (tube). This reduces the harmful side
  effects of myoglobin. The increase in the amount
  of fluids due to intravenous hydration helps the
  kidneys to get rid of myoglobin. Blood
  Transfusion In this procedure, the patient is
  given fresh blood via an intravenous line. Blood
  transfusion is done to replace the blood
  containing high amount of myoglobin and other
  substances with healthy blood. 

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Treatments
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• Dialysis This is a technique in which toxic
  substances are removed from the blood. This
  method is used only when the kidneys are not able
  to do their task of cleaning the blood.
  The dialysis machine is used to filter the blood.
  Dialysis may be required for a short period or
  for the rest of the life depending upon the
  severity of the condition. Surgery Surgical
  procedure involves cutting the tissues that cover
  the muscles. This reduces the pressures on the
  nerves and blood vessels caused by the
  inflammation of the injured muscle. Proper
  hydration is essential after conditions that
  involve injury to the skeletal muscle. Also,
  after a strenuous exercise, one must not forget
  to consume plenty of fluids. This is necessary to
  dilute the urine, and eliminate the myoglobin
  protein out of the kidneys. With prompt
  treatment, severe complications can definitely be
  avoided, thereby increasing the chances of
  complete recovery.

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