Rhabdomyolysis
GENERAL INFORMATION:
What is rhabdomyolysis? Rhabdomyolysis (rab-do-MI-oli-sis) is a condition where skeletal muscle cells die following an injury. Skeletal muscle cells are found in the muscles of your arms and legs. When muscle cells are injured, they break down and release large amounts of substances into the blood. This may include substances such as potassium, phosphate, creatinine kinase, and myoglobin. Potassium levels higher than normal are harmful to the heart. Myoglobin gives muscles their red color. It is normally passed in urine, but is harmful to the kidneys if large amounts are passed in the urine.
What causes rhabdomyolysis? An injured muscle that releases large amounts of harmful substances into the blood causes rhabdomyolysis. The following things may cause injury to the muscles:
- Diseases: This includes conditions such as seizures (convulsions), severe asthma, and infections by germs, called bacteria or viruses. Too much vomiting or diarrhea, diabetes, or problems of hyperthyroidism (thyroid storm) may also injure the muscles.
- Temperature extremes: This includes developing hyperthermia (very high body temperature), or hypothermia (very low body temperature).
- Extreme muscular activity: This may be after a hard and long-term exercise, such as in running marathons.
- Medicines and other harmful substances: Aspirin or diuretics (water pills) overdose may cause an electrolyte imbalance. Antidepressants or anti-cholesterol medicines may also injure the muscles. Illegal drugs such as amphetamines, opiates, ecstasy, and LSD may also cause muscle injury.
- Trauma: A crushing injury, electrical shock, or severe burns.
What are the signs and symptoms of rhabdomyolysis? The more common signs and symptoms include pain, swelling, and weakness in your legs, arms, or lower back. You may also have any of the following:
- A dark or tea-colored urine, blood in the urine, or passing too little or no urine at all.
- Bruising of muscles.
- Fast heartbeats.
- Mental confusion or easy irritation.
- Nausea (feeling sick to the stomach) and vomiting (throwing up).
- Trouble breathing.
How is rhabdomyolysis diagnosed? You may need one or more of the following tests:
- Biopsy: Your caregiver removes a small piece of muscle tissue and sends it to the lab for tests. Before the tissue is removed, your skin will be cleaned, and medicine used to numb the area. After the biopsy, you may need stitches to close the wound. A bandage may cover the biopsy area.
- Blood tests: Creatine kinase is a substance made by injured muscles. The creatine kinase test checks for the presence of creatine kinase in your blood.
- Computed tomography scan: This test is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your muscles. Your caregivers look at the pictures for changes in your muscle density. Before taking the pictures, you may be given dye through an IV in your vein. The dye helps caregivers to see the pictures clearly. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.
- Magnetic resonance imaging: This test is also called MRI. An MRI allows caregivers to see inside your body. During the MRI, pictures are taken of your muscles. Caregivers use these pictures to look for muscle changes or injuries.
- Urine sample: A sample of your urine is collected and sent to a lab for tests. Your caregiver may give you a special wipe and clean cup. Use the wipe to clean the skin around the opening where you pass urine. Urinate into the clean cup. Put the lid on the cup. Do not touch the inside of the cup or the lid. Give the urine sample to your caregiver.
How is rhabdomyolysis treated? Rhabdomyolysis is treated by intravenous (IV) hydration. A tube is inserted into your blood vessel and fluids are given to you through the tube. To treat rhabdomyolysis, IV hydration is done as soon as possible with large amounts of fluid. This decreases the harmful effects of myoglobin and other substances. The increase in body fluids helps the kidneys pass out myoglobin and other harmful substances through the urine. Other medicines may be added to the IV, such as:
- Mannitol and certain diuretics: These medicines help your body get rid of fluid. They also help flush out myoglobins that may collect in your kidneys.
- Sodium bicarbonate: This medicine reduces the acidity of urine less acid and the harmful effects of myoglobin to your kidneys.
- Blood transfusion: During a blood transfusion, you will get whole blood, or parts of blood through an IV. Many people are worried about getting AIDS, hepatitis, or West Nile Virus from a blood transfusion. The risk of this happening is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus. If you refuse a blood transfusion, your condition may get worse, and you may die.
- Dialysis: Dialysis cleans your blood when your kidneys cannot. Extra water, chemicals, and waste products are removed from your blood by a dialyzer or dialysis machine. The dialysis machine does this by passing your blood through a special filter, then returning it back to you. You may need dialysis for a short time, or for the rest of your life. Caregivers will check your vital signs often during dialysis. You may also be given medicines or have blood taken for lab tests during dialysis.
- Surgery: You may need a surgery called fasciotomy. This is surgery to cut tissues covering the muscles. This decreases pressure on blood vessels and nerves caused by swelling of the injured muscle.
Where can I find more information? Having rhabdomyolysis is a life-changing disease for you and your family. Accepting that you have rhabdomyolysis may be hard. You and those close to you may feel sad and worried. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Contact the following organizations for more information:
- American Association of Kidney Patients
3505 E. Frontage Rd, Suite 315
Tampa, FL 33607-1796
Phone: 1-800-749-2257
Web Address: http://aakp.org
- American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
Phone: 1-913-906-6000
Web Address: http://www.aafp.org
- Society of Critical Care Medicine
701 Lee Street, Suite 200
Des Plaines, IL 60016
Phone: 1-847-8276869
Web Address: http://www.sccm.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
| Link to this page |  |
Printable Version |  |
Email Page |
