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Rhabdomyolysis

Rhabdomyolysis Overview

Rhabdomyolysis describes the situation in which muscle in the body is damaged (rhabdomyo=skeletal muscle + lysis= rapid breakdown). There are a variety 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 kidney failure, which is 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 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.



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Rhabdomyolysis

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