Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Rhabdomyolysis is a condition that may occur when muscle tissue is damaged
due to an injury in which muscle
in the body is damaged (rhabdomyo=skeletal muscle + lysis= rapid breakdown).
There are a three of types of muscle in the body, including:
Rhabdomyolysis occurs when there is damage to the skeletal muscle.
The injured muscle cell leaks
myoglobin (a protein) into the
blood stream. Myoglobin can be directly toxic to kidney cells, and it can impair
and clog the filtration system of the kidney. Both mechanisms can lead to
failure (the major complication of rhabdomyolysis).
Significant muscle injury can cause fluid and
electrolyte shifts from the bloodstream into the damaged muscle cells, and in the other direction
(from the damaged muscle cells into the bloodstream). As a result, dehydration may occur. Elevated levels of
potassium in the bloodstream (hyperkalemia) may be associated with
heart rhythm disturbances and
sudden cardiac death due to ventricular tachycardia and ventricular fibrillation.
Complications of rhabdomyolysis also include disseminated intravascular coagulation, a
condition that occurs when small blood clots begin forming in the
body's blood vessels. These clots consume all the clotting factors and platelets
in the body, and bleeding
begins to occur spontaneously.
When muscles are damaged, especially due to a
crush injury, swelling
within the muscle can occur,
causing compartment syndrome. If this occurs in an area where the muscle is
bound by fascia (a tough fibrous tissue membrane), the pressure inside the
muscle compartment can increase to the point at which blood supply to the muscle
is compromised and muscle cells begin to die.
Rhabdomyolysis was first appreciated as a significant complication from crush
and blast injuries sustained in a volcano eruption in Italy, in 1908. Victims of
the blast injuries during the first and second World Wars help further
understand the relationship between massive muscle damage and kidney failure.
What Is the Definition of Rhabdomyolysis,
and What Are the Symptoms and Causes?
Rhabdomyolysis is a condition in which skeletal muscle cells break down,
releasing myoglobin (the oxygen-carrying pigment in muscle) together with
enzymes and electrolytes from inside the muscle cells. The risks with
rhabdomyolysis include muscle breakdown and kidney failure since myoglobin is
toxic to the kidneys.
Rhabdomyolysis can occur from extensive muscle damage as, for example, from a
crushing injury or an electrical shock. Drugs or toxins, particularly some of
the cholesterol lowering medications from the class of drugs called "statins," may cause
this disorder. Underlying diseases such as systemic lupus erythematosus can also
lead to rhabdomyolysis. It is a common complication of major burns.
The key signs and symptoms of rhabdomyolysis include:
dark, red, or cola
colored urine, and
muscle tenderness, stiffness, aching (myalgia) or weakness.