Rhabdomyolysis
By Stuart Seys
About Rhabdomyolysis
Statins
Rhabdomyolysis is caused by any condition that damages skeletal muscle, especially injury. Although mild muscle pain is a relatively common side effect of statins, some people who take statin medications to lower their cholesterol may have severe muscle pain. This intense pain is a symptom of rhabdomyolysis.
Cases in Iowa
13 Iowa football players were hospitalized from exertional rhabdomyolysis. This was a consequence of intense strength training.
Going Too Far
Working muscles beyond the point of fatigue is a common way to develop exertional rhabdomyolysis. When reaching the point where you can't lift weights anymore, your muscle fibers have ripped and started to release contents into the bloodstream. One of these things is a protein called myoglobin. Your kidneys can break down myoglobin, but can be overwhelmed by a lot of it. This can cause them to shut down, and allow toxins into your blood. The myoglobin then passes into your urine, turning it to a reddish-brown color, a common side effect of rhabdomyolysis.
Media Influences
Between 3/13/12- 3/15/12, 28 officers and sergeants participated in a 3 day training course at the Police Academy in Murray Hill neighborhood of Manhattan. Between 3/15/12- 3/19/12, 10 out of the 28 people were hospitalized for rhabdomyolysis.
Interpersonal Communication
Coaches- You could go to your coaches and ask them for a different lifting schedule, or if it would be possible to skip a few days of lifting to recover.
Immediate and Long Term Risk Factors
- Heatstroke
- Seizures
- Shaking chills
- Severe exertion, such as marathon running or calisthenics
- Extreme muscle strain, especially in someone who is an untrained athlete. This can happen in elite athletes too, however. And it can be more dangerous if there is more muscle mass to break down.
Long Term Risk Factors
- Viral infections such as the flu, HIV, or herpes simplex virus
- Bacterial infections leading to toxins in tissues or the bloodstream (sepsis)
- Ischemia or necrosis of the muscles (which may occur with arterial occlusion, deep venous thrombosis, or other conditions)
- Genetic muscle diseases
- Alcoholism(with muscle tremors)
- Drugs, especially cocaine, amphetamines, statins, heroin, or PCP
Advances
- Getting fluids that contain bicarbonate may prevent kidney damage by quickly flushing myoglobin out of the kidneys. Fluids may need to be given through a vein (by IV). Some patients may need kidney dialysis.
- Medicines that may be prescribed include diuretics and bicarbonate (if there is enough urine output).
- Hyperkalemia and low blood calcium levels (hypocalcemia) should be treated right away, if present. Kidney failure should also be treated.
Sources
http://www.nlm.nih.gov/medlineplus/ency/article/000473.htm
http://www.webmd.com/a-to-z-guides/rhabdomyolysis-symptoms-causes-treatm
Mayo Clinic Health System
Address: 1025 Marsh Street, Mankato, MN 56001
Phone: (507) 625-4031
Thomas Behrenbeck, M.D., Ph.D.