Recurrent exertional rhabdomyolysis: coincidence, syndrome, or acquired myopathy?
The purposes of this report are to review and discuss the issue of recurrent exertional rhabdomyolysis (ER), the return to physical activity after ER, and the possible causes of recurrence, with special consideration to metabolic myopathies and the possibility of an acquired post-ER myopathy. We discuss the medical investigation required prior to return to physical activity after an episode of ER and suggest two possible mechanisms for recurrence of ER in the absence of a known cause: premature return to activity and an acquired post-ER muscular disorder. We also emphasize the need to create proper guidelines for return to physical activity after ER and, for further investigation, the possible mechanisms of ER recurrence in patients without a known metabolic myopathy.
1Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel; and 2The IDF Institute of Military Physiology, Tel Hashomer, Israel.
Danit
D
Atias
Amit
A
Druyan
Yuval
Y
Heled
D003937:Diagnosis, Differential; D006801:Humans; D005082:Physical Exertion; D017410:Practice Guidelines as Topic; D012206:Rhabdomyolysis / Q000175:diagnosis* / Q000517:prevention & control*; D055502:Secondary Prevention; D013178:Sports Medicine / Q000592:standards*; D014481:United States