Rhabdomyolysis. The role of diagnostic and prognostic factors

Abstract

Rhabdomyolysis, literally meaning the breakdown of muscle tissue, is a common syndrome with many causes, acquired ones such as exertion, trauma, infections, temperature extremes, drugs, toxins, electrolyte and endocrine abnormalities, and congenital ones such as myopathies and connective tissue disorders. All results in a common pathophysiologic pathway which ends with the dispersing of muscle tissue content into the circulation. Rhabdomyolysis has characteristic clinical, laboratory and radiologic features, but does require a high index of suspicion so that the diagnosis would not be missed. The sensitivity and specificity of the various characteristics, as well as clinical guidelines, are discussed in this paper. The syndrome may present with several complications, e.g. arrhythmias, electrolyte abnormalities, acute renal injury, acidosis, volume depletion, compartment syndrome and disseminated intravascular coagulation. The prognosis is highly variable and depends on the underlying etiologies and complications, but is in general considered as good. The milestone of treatment is vigorous fluid resuscitation. Treatment options, in practice and in research, are discussed in the following pages.

Acute Rhabdomyolysis Following Epidural Steroid İnjection: An unusual Complication in a Low Back Pain Patient

“…However, there may be no signs of muscle involvement. [3] In our case; the patient presented with fever, incontinence, rigors with generalized myalgia in both legs and difficulty walking. Her temperature was 38 degree celsiua.…”

MR Imaging of Atraumatic Muscle Disorders

“…Muscle damage of sufficient severity from any cause can result in myonecrosis. Causes include compartment syndrome, diabetes, trauma, exercise, heatstroke, radiation, infection, metabolic disorders, seizures, envenomation, toxins, and medicinal or illicit drug use (51,53). Clinical findings can be nonspecific, and muscle pain may not be a prominent feature.…”

Rhabdomyolysis diagnosed in an older woman with dementia on examination after a wandering episode

“…Although she had been taking the same medication for nearly 10 years without rhabdomyolysis, donepezil was difficult to exclude as a cause, because the drug can cause rhabdomyolysis. 4 Moreover, dehydration is generally a contributing factor of rhabdomyolysis, 5 and aging is reported to be a poor prognostic factor of rhabdomyolysis, 3 both of which are related to wandering. Therefore, we presumed that her wandering and its associated features, such as dementia medication, strenuous exercise, dehydration and aging, had led to rhabdomyolysis.…”