What is rhabdomyolysis?
Rhabdomyolysis is an acute condition in which muscle tissue breaks down rapidly and releases its contents into the bloodstream. This includes proteins such as myoglobin and enzymes such as creatine kinase (CK), which in high levels can be harmful to the body, especially the kidneys.
The condition varies in severity from mild cases with transient symptoms to serious situations with the risk of kidney failure and other complications.
What happens in the body with rhabdomyolysis?
In rhabdomyolysis, muscle cells are damaged, causing their contents to leak into the bloodstream.
Cell damage: Muscle fibers break down and cell membranes lose their integrity.
Myoglobin release: Myoglobin, an oxygen-binding protein in muscles, is released and filtered through the kidneys, where it can cause damage.
Electrolyte disturbances: Substances such as potassium and phosphate are released into the blood, which can affect the heart and nervous system.
Inflammation: The body reacts with an inflammatory response that can contribute to further tissue damage.
Common causes of rhabdomyolysis
Rhabdomyolysis can be triggered by several different factors, often in combination:
Intense physical exertion: Especially during high or extreme exercise.
Trauma or pressure injuries: For example, in accidents or prolonged pressure on muscles.
Drugs and substances: Certain drugs, such as statins, can in rare cases contribute to muscle breakdown.
Infections: Viruses and bacteria can affect muscle tissue.
Heat and dehydration: Dehydration and overheating increase the risk.
Symptoms - how is rhabdomyolysis diagnosed?
Symptoms can vary depending on the severity, but classic signs include:
Muscle pain and tenderness, often in larger muscle groups
Weakness or decreased muscle strength
Swelling in affected muscles
Dark-colored urine (tea-colored), which is a sign of myoglobinuria
In more severe cases, symptoms such as fatigue, nausea, and heart failure may occur.
How is the diagnosis made?
The diagnosis of rhabdomyolysis is based on clinical symptoms in combination with blood tests.
Elevated creatine kinase (CK): One of the most important findings and is often significantly elevated, >50 µkat/L.
Also CRP can provide information about the degree of inflammation.
Electrolytes: Abnormalities in potassium and other salts may occur.
Kidney function: Creatine and eGFR are usually checked to detect possible kidney damage.
Treatment of rhabdomyolysis
Rhabdomyolysis is a potentially serious condition that requires medical evaluation. Treatment aims to protect the kidneys and stabilize the body's balance.
Fluid therapy: Intravenous fluids are used to dilute and eliminate myoglobin via the kidneys.
Monitoring: Blood tests are closely monitored to detect electrolyte disturbances and kidney damage.
Treat the cause: Identification and treatment of the underlying factor is crucial.
In milder cases, rest and fluid intake may be sufficient, but if rhabdomyolysis is suspected, medical evaluation should always be performed.
When should you seek medical attention?
You should always seek medical attention if you experience severe muscle pain combined with weakness, swelling, or dark-colored urine, especially after intense physical activity or illness. Early diagnosis and treatment are crucial to reduce the risk of complications.