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[Acute rhabdomyolysis].

V Briner, A Colombi, W Brunner

Schweizerische Medizinische Wochenschrift

|February 15, 1986

Summary

This summary is machine-generated.

Acute rhabdomyolysis, a condition damaging muscle cells, causes significant electrolyte shifts and is diagnosed by high creatine kinase (CK) levels and myoglobinuria. It often results from acquired causes like trauma, intoxication, or muscular stress.

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Area of Science:

Nephrology
Internal Medicine
Biochemistry

Background:

Rhabdomyolysis involves muscle cell membrane damage, leading to electrolyte imbalances and release of intracellular components.
Diagnosis relies on elevated serum creatine kinase (CK) activity and detecting myoglobinuria via dipstick test, excluding hematuria or hemoglobinuria.

Observation:

The study reviewed 61 patients with rhabdomyolysis over 15 years, with 49 diagnosed in the last 4.5 years based on CK > 5000 U/L.
Rhabdomyolysis is increasingly recognized due to muscular stress, coma, paralysis, and intoxication (24% of cases), often with multiple contributing factors (70%).
Other triggers include autoimmune diseases, infections, endocrinopathies, and thermal/ischemic injuries.

Findings:

Common electrolyte disturbances include initial hypocalcemia (80%), hyperkalemia, hyperphosphatemia, and a widened anion gap.

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Compartment syndrome can develop, causing vascular or neural deficits.

Disseminated intravascular coagulation was observed in 6 of 13 patients, and 30 patients developed acute renal failure, with 15 requiring dialysis or hemofiltration.

Implications:

Understanding the diverse causes and complications of rhabdomyolysis is crucial for timely diagnosis and management.
Prompt identification and treatment of electrolyte imbalances and potential renal failure are vital for patient outcomes.
The rising incidence highlights the need for awareness regarding non-traumatic causes like muscular stress and intoxication.