Rhabdomyolysis

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Rhabdomyolysis facts

  • Rhabdomyolysis is the rapid destruction of skeletal muscle resulting in leakage into the urine of the muscle protein myoglobin.
  • Rhabdomyolysis has many causes.
  • Medications can cause muscle injury and rhabdomyolysis.
  • Rhabdomyolysis can cause muscle pain and weakness.
  • Blood levels of muscle enzymes, including CPK, SGOT, SGPT, and LDH, as well as blood and urine myoglobin are used to diagnose and monitor rhabdomyolysis.
  • Hospitalization is sometimes required to treat rhabdomyolysis.

What is rhabdomyolysis?

Rhabdomyolysis (RAB-DOE-MY-O-LIE-SIS) is the rapid destruction of skeletal muscle resulting in leakage into the urine of the muscle protein myoglobin.

There are three different types of muscle in the human body;

  1. smooth muscle,
  2. skeletal muscle, and
  3. heart muscle.

The skeletal muscle is the muscle of movement of the body (moving the skeleton at the joints). Skeletal muscle is affected by rhabdomyolysis.

Myoglobin is a protein component of the muscle cells that is released into the blood when the skeletal muscle is destroyed in rhabdomyolysis. Creatine kinase is an enzyme (a protein that facilitates chemical reactions in the body) also in the muscle cells. The level of each of these proteins can be measured in blood to monitor the degree of muscle injury from rhabdomyolysis. Myoglobin can also be measured in samples of urine.

What causes rhabdomyolysis?

Rhabdomyolysis has many causes. Some of the common ones include:

  • Muscle trauma or crush injury
  • Severe burns
  • Physical torture or child abuse
  • Prolonged lying down on the ground (people who fall or are unconscious and are unable to get up for several hours)
  • Prolonged coma
  • Severe muscle contractions from prolonged seizures
  • Cocaine use with related hyperthermia (increased body temperature)
  • Extreme physical activity (running a marathon, extreme workouts)
  • Drug and alcohol intoxication
  • Low circulating phosphate, potassium, or magnesium levels in the blood (electrolytes)
  • Genetic muscle diseases (familial paroxysmal rhabdomyolysis)
  • Prolonged drowning or hypothermia (low core body temperature)
  • Medications: most notably statins used to treat high cholesterol (simvastatin [Zocor], atorvastatin [Lipitor], pravastatin [Pravachol], or lovastatin [Mevacor]) and other medications such as Parkinson's medication, psychiatric medications, anesthesia medications, HIV medications, colchicine
  • Variety of viruses and some bacteria
  • Severe hypothyroidism (low thyroid level), especially if the person is also taking statin drugs for cholesterol
  • Lack of blood perfusion to a limb
  • Some inflammatory disorders of the muscle, called myopathies, (myositis, dermatomyositis, polymyositis)
  • Venom from certain snake bites (mainly in Africa, Asia, and South America)
Medically Reviewed by a Doctor on 11/8/2013

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Rhabdomyolysis Symptoms and Causes

Rhabdomyolysis (rhabdo=skeleton +myo=muscle + lysis=breakdown) is a condition in which muscles break down quickly and spill their contents into the blood stream. Myoglobin is a protein that is contained in muscle cells, and if enough is spilled into the blood stream, it can clog the kidney's filtering system and lead to kidney failure and a variety of other serious medical consequences and complications. While muscles routinely get sore after physical activity, rhabdomyolysis takes that muscle injury to a higher level.

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