Rhabdomyolysis

Question 1

What is rhabdomyolysis?

Answer 1

A condition where skeletal muscle breaks down and releases the breakdown products into the blood

Question 2

What can cause rhabdomyolysis?

Answer 2

• Extreme overuse of skeletal muscle, e.g. extreme exercise, seizures
• Extreme underuse of skeletal muscle, e.g. prolonged immobility
• Traumatic injury, e.g. crush injuries, fall + long lie in frail patients

Question 3

Which breakdown products are released into the blood in rhabdomyolysis? What effects do thee breakdown products cause?

Answer 3

• Myoglobin (AKI as nephrotoxic in high concentrations)
• Potassium (hyperkalaemia, arrythmias, cardiac arrest)
• Phosphate
• Creatine kinase/CK

Question 4

What are the symptoms/signs of rhabdomyolysis?

Answer 4

• Muscle aches/pains

- Red-brown urine (myoglobinuria)

Question 5

Which investigation can be used to diagnose rhabdomyolysis? What level would you expect in rhabdomyolysis?

Answer 5

Creatine kinase (CK) - which will be in the thousands at least

Question 6

Which electrolyte is important to monitor in rhabdomyolysis?

Answer 6

Potassium

Question 7

Describe the management of rhabdomyolysis

Answer 7

• Mainstay of treatment is supportive with IV fluids (to encourage filtration of breakdown products into the urine)
• Treatment of hyperkalaemia may also be required