Excretion of myoglobin in urine after cardiac catheterisation.

Donald, TC; Cloonan, M. J.; Wilcken, D. E. L.

doi:10.1136/hrt.40.11.1237

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…The other is that rhabdomyolysis is secondary to the combined adverse effect of these two agents. On the other hand, we can not prove whether or not [13,14]. However, we could not find any report regarding rhabdomyolysis associated with it.…”

Section: Discussioncontrasting

confidence: 41%

Rhabdomyolysis in a Healthy Peripheral Blood Stem Cell Donor following Mobilization with Filgrastim

Hacioglu

Altuntaş²,

Kaynar³

et al. 2009

Transfus Med Hemother

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Background: Although granulocyte colony stimulating factor (G-CSF) mobilization is generally well tolerated by healthy donors, there is also a wide spectrum of adverse events associated with it. Among these events, rhabdomyolysis in peripheral blood stem cell (PBSC) donors is very rare. In this paper, we present a first case of rhabdomyolysis after administration of filgrastim for PBSC mobilization. Case Report: A 6-year-old donor received 10 μg/kg/day filgrastim subcutaneously for 5 days. On the 3rd day of filgrastim, the donor complained of bone pain; a single dose of paracetamol (250 mg) was given to relieve pain. On the 4th day, she complained of bone pain, myalgia, and vomiting. On laboratory analysis, serum creatine phosphokinase was 1,095 U/l (40–226 U/l), LDH 312 U/l (100–190 U/l), aspartate aminotransferase 85 U/l (0–40 U/l), potassium 3.3 mmol/l (3.6–5.1 mmol/l). Urine myoglobin was 110 ng/ml (<5 ng/ml). Rhabdomyolysis was suspected on clinical and laboratory findings. Clinical manifestations regressed and the laboratory results returned to normal within three days after intravenously forced diuresis and potassium replacement. Stem cells were successfully harvested from peripheral blood on the 5th day of G-CSF therapy. Conclusion: Rhabdomyolysis is a rare but important adverse effect of G-CSF. Allogeneic PBSC donors should be closely monitored with regard to rhabdomyolysis after G-CSF administration in the mobilization setting.

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Section: Discussioncontrasting

confidence: 41%

Rhabdomyolysis in a Healthy Peripheral Blood Stem Cell Donor following Mobilization with Filgrastim

Hacioglu

Altuntaş²,

Kaynar³

et al. 2009

Transfus Med Hemother

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“…It attributes the increase in serum myoglobin to the use of intramuscular injections of drugs as premedication, and refutes the proposition that abnormalities in myoglobin after cardiac catheterisation indicate myocardial necrosis. 6 …”

Section: Discussionmentioning

confidence: 99%

“…6 This was attributed to transient and perhaps reversible myocardial injury. All the 146 patients had received premedication by intramuscular injection.…”

mentioning

confidence: 99%

Serum myoglobin after cardiac catheterisation.

McComb¹,

McMaster²

1982

Heart

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SUMMARY Study of 80 consecutive patients undergoing elective diagnostic cardiac catheterisation showed that after the procedure 25 (31%) developed myoglobinaemia. This was attributed to complications of the catheterisation in two. The remaining 23 had received premedication by intramuscular injection. In patients without intramuscular injections myoglobinaemia did not occur after uncomplicated cardiac catheterisation.The study did not support the proposition that cardiac catheterisation results in myocardial damage which can be detected by abnormalities of myoglobin but not by conventional indications of myocardial necrosis.Cardiac catheterisation,' and in particular coronary arteriography,2 have a significant morbidity and mortality; myocardial infarction occurs in a small proportion of patients34 and angina pectoris in a further number.5 Urinary myoglobin has been measured after routine cardiac catheterisation using an indirect haemagglutination method;6 it was detected in 39 (27%) of 146 patients.6 This was attributed to transient and perhaps reversible myocardial injury. All the 146 patients had received premedication by intramuscular injection.Excretion of myoglobin in the urine was first described after extensive skeletal muscle injury.7 It has since been found to be a reliable indicator of myocardial infarction. Eighty consecutive patients undergoing elective cardiac catheterisation were studied. The patients were randomised into two groups, so that half received premedication orally, and half by intramuscular injection. The premedicant drug was determined by the physician undertaking the catheterisation. Most patients received 10 mg diazepam (Valium). Some were given 50 mg pethidine and 25 mg promethazine (Phenergan). One received 25 mg pethidine, 6.25 mg chlorpromazine, and 6*25 mg promethazine. Premedication was given one hour before the catheterisation was started.A venous blood sample was obtained before the administration of the premedication and one, four, eight, and 24 hours after it. Serum creatine kinase was measured in all samples, using an automated method. Serum myoglobin was measured in all samples by radioimmunoassay. Serum aspartate transaminase, lactic dehydrogenase, and blood urea were measured in the first and last samples.Electrocardiograms were recorded before and after the catheterisation. The contrast medium used in all cases was Urografin 370 (meglumine diatrizoate and sodium diatrizoate).

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“…A functional classification of myoglobinuria best begins with adivision into hereditary and sporadic forms because recognition of the hereditable enzyme abnormalities suggests modes of pathogenesis (Tables 2, 3). However, there is often more than Data from Adams et al (1978); Donald (1978); Kagen (1978; Knochel (1982); Malvano et al (1978) Markowitz andWobig (1977); Sarachak and Bernstein (1974) Stone etal. (1975).…”

Section: A Classification Of Myoglobinuria Based On Pathogenesismentioning

confidence: 99%

Myoglobinuria, 1984

Rowland

1984

Can. j. neurol. sci.

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The year is included in the title of this review because the subject is the diversity of conditions that result in myoglobinuria, and new causes keep appearing as conditions in society change or new drugs are introduced. The syndrome is often linked to seamier aspects of society or medicine : war; sadistic drill sergeants; drug abuse; attempted suicide; self-medication or inadequate supervision of drug therapy. On the other hand, study of myoglobinuric syndromes has informed us about new hereditable biochemical causes and we have learned more about the action of viruses on muscle.

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Excretion of myoglobin in urine after cardiac catheterisation.

Cited by 5 publications

References 7 publications

Rhabdomyolysis in a Healthy Peripheral Blood Stem Cell Donor following Mobilization with Filgrastim

Rhabdomyolysis in a Healthy Peripheral Blood Stem Cell Donor following Mobilization with Filgrastim

Serum myoglobin after cardiac catheterisation.

Myoglobinuria, 1984

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