Rhabdomyolysis - Causes and Signs of Rhabdomyolysis

The main types of pathology:

• hypoketotic hypoglycemia;
• recurrent rhabdomyolysis;
• myopathy with deficiency of carnitine palmitoyltransferase type II.

Causes

The main cause of the disease is the breakdown of muscle cells, as a result of which myoglobin enters the circulatory system. In the acidic environment of the kidneys, myoglobin is transformed into hematin and contributes to the clogging of the renal tubules, which is accompanied by the formation of renal failure.

Dead muscle cells do not feel the need for creatine, which enters the blood and turns into creatinine. In order to overcome creatininemia, the body needs to produce a large amount of creatine phosphokinase, which disrupts homeostasis.

Myoglobin is toxic to humans, especially when it enters the bloodstream in large quantities. This has a negative effect on the tissue metabolism process.

Also among the factors contributing to the development of the disease, the following are distinguished: prolonged compression syndrome, heredity, infections and viral diseases accompanied by an increase in temperature, taking certain medications, increased physical activity, burns.

People who abuse alcohol and smokers are extremely likely to develop pathology. The disease often develops in people who use drugs.

Sometimes there are cases of the disease appearing due to the bite of some reptiles and animals or when eating poisonous mushrooms.

Symptoms

At the initial stage of the disease, people complain of local swelling, followed by pain in the muscles, limiting movement exclusively in the affected area, and subsequently becoming total and often leading to paralysis. Along with this, other symptoms may appear:

• weakness;
• noise in the ears;
• pain in the lower back.

Urine usually acquires a dark color. Its volume decreases significantly and after some time urination stops. As a result, renal failure develops. If any of the above symptoms are detected, a consultation with a neurologist or orthopedist is required.

Diagnostics

During the consultation, the doctor will examine the patient, listen to his complaints, study the symptoms and give recommendations. It is mandatory to give blood and urine for analysis. Electromyography and biopsy are indicated for the purpose of differentiation of the disease.

Treatment

Home rest, plenty of fluids, the use of rehydration methods are the therapeutic therapy for mild forms of the disease. Intensive monitoring of urine pH, electrolytes, as well as acid-base balance, ECG indicators is indicated for severe forms of the pathology.

Intravenous drips with saline solution are done to prevent the occurrence of shock, increase fluid movement in the kidneys, and reduce the concentration of toxins. The use of furosemide and mannitol is supposed to increase osmosis and reduce kidney damage.

In case of complications in the form of disseminated intravascular coagulation, transfusion of frozen plasma is prescribed.

Surgical intervention is performed depending on the severity of the pathological process. In case of severe tissue compression, fasciotomy is prescribed.

Prevention

In order to prevent the development of the disease, muscle injuries should be treated promptly.