Rhabdomyolysis

  • Medical Author:
    Siamak N. Nabili, MD, MPH

    Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What are the symptoms of rhabdomyolysis?

RhRhabdomyolysis may not cause any symptoms at all. Muscle aches and pain (myalgia), stiffness, and muscle weakness can occur with rhabdomyolysis, and is especially common with severe muscle damage. Rhabdomyolysis may cause a darkening of the urine color. Myoglobin is released from the muscles when they break down and is excreted into the urine. This can cause a red or cola color of the urine.

What should I do if I think I have rhabdomyolysis?

If you have signs and symptoms suggestive of rhabdomyolysis, your doctor needs to be notified promptly. It is important to realize that these symptoms are not specific for rhabdomyolysis as they may be caused by other conditions.

How is rhabdomyolysis diagnosed?

Rhabdomyolysis is suggested by the history of recent and past events and the physical examination. It is confirmed by blood and urine testing. An important part of diagnosing rhabdomyolysis is a comprehensive medical history and physical examination.

The medical history may include questions about any medication use, drug and alcohol use, other medical conditions, any trauma or accident, etc. Blood tests include a complete blood count (CBC), a metabolic panel, muscle enzymes, and urinalysis.

The diagnosis of rhabdomyolysis is confirmed by detecting elevated muscle enzymes in blood, which include creatine phosphokinase (CPK), SGOT, SGPT, and LDH . The levels of these enzymes rise as the muscle is destroyed in rhabdomyolysis.

While the SGOT, SGPT, and LDH enzymes are found in muscles, they are more frequently associated with the liver. Therefore, elevations of SGOT and SGPT, without elevated CPK, are more typically indications of liver damage.

Of note, CPK is also in heart muscle (cardiac muscle) and brain. The laboratory is usually able to distinguish between the different components of this enzyme. For example, the fraction coming from skeletal muscle is referred to as CK-MM and the one from heart muscle is designated as CK-MB. There are small amounts of the CK-MB component in the skeletal muscle as well.

The levels of myoglobin can be elevated in blood and urine

Medically Reviewed by a Doctor on 2/9/2015

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