What are the clinical findings of rhabdomyolysis?

Main clinical manifestations – The clinical manifestations of rhabdomyolysis include myalgias, weakness, red to brown urine due to myoglobinuria, and elevated serum muscle enzymes, including creatine kinase (CK). The degree of myalgias and other symptoms varies widely, and some patients are asymptomatic.

What is the classic triad of symptoms in rhabdomyolysis?

The classic triad of symptoms of rhabdomyolysis consists of myalgia, weakness, and tea-colored urine.

What lab values indicate rhabdomyolysis?

Blood tests include a complete blood count (CBC), a metabolic panel, muscle enzymes, and urinalysis. The diagnosis of rhabdomyolysis is confirmed by detecting elevated muscle enzymes in the blood, which include creatine phosphokinase (CPK), SGOT, SGPT, and LDH.

Why is calcium low in rhabdomyolysis?

Hyperphosphatemia causes the deposition of calcium phosphate on the destroyed muscle cells and other tissues, resulting in early hypocalcemia during rhabdomyolysis. During cellular necrosis, calcium, initially combined with muscle cells, is released back into the plasma.

Are CPK and CK the same?

Creatine kinase (CK) is also known as creatine phosphokinase (CPK) and is an enzyme that catalyzes the phosphorylation of creatine. Creatine kinase is a dimer that exists as isoenzymes with greatest activity in muscle (CK-MM), heart (CK-MB), and brain (CK-BB) (Lang, 1981).

What is the main electrolyte disturbance in rhabdomyolysis?

Electrolyte abnormalities are prominent features of rhabdomyolysis. Hyperphosphatemia, hyperkalemia, hypocalcemia (early), hypercalcemia (late) hyperuricemia, and hypoalbuminemia have been described. Hyperkalemia may be a result of both muscle injury and renal insufficiency or failure.

What toxins cause rhabdomyolysis?

Environmental toxins that may cause rhabdomyolysis include the following:

  • Carbon monoxide.
  • Toluene.
  • Hemlock herbs from quail – Rhabdomyolysis after the consumption of quail is well known in the Mediterranean region; it occurs as the result of intoxication by hemlock herbs that the quails consume.

What CPK level is rhabdomyolysis?

In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications.

Is lactic acid elevated in rhabdomyolysis?

A metabolic acidosis develops in severe rhabdomyolysis secondary to lactic acid production from ischaemic muscle and the release of other organic acids. Hypocalcaemia is frequently recorded in early rhabdomyolysis owing to calcium accumulation in damaged muscle.