title: Diagnostic evaluation of rhabdomyolysis.
abstract: Rhabdomyolysis is characterized by severe acute muscle injury resulting in muscle pain, weakness, and/or swelling with release of myofiber contents into the bloodstream. Symptoms develop over hours to days after an inciting factor and may be associated with dark pigmentation of the urine. Serum creatine kinase and urine myoglobin levels are markedly elevated. Clinical examination, history, laboratory studies, muscle biopsy, and genetic testing are useful tools for diagnosis of rhabdomyolysis, and they can help differentiate acquired from inherited causes of rhabdomyolysis. Acquired causes include substance abuse, medication or toxic exposures, electrolyte abnormalities, endocrine disturbances, and autoimmune myopathies. Inherited predisposition to rhabdomyolysis can occur with disorders of glycogen metabolism, fatty acid β-oxidation, and mitochondrial oxidative phosphorylation. Less common inherited causes of rhabdomyolysis include structural myopathies, channelopathies, and sickle-cell disease. This review focuses on the differentiation of acquired and inherited causes of rhabdomyolysis and proposes a practical diagnostic algorithm. Muscle Nerve 51: 793-810, 2015.
authors: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: Jessica R
authors: JR
authors: Nance
authors: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.|Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Building 50, Room 1146, Bethesda, Maryland, 20892, USA.
authors: Andrew L
authors: AL
authors: Mammen
mesh_terms: D006801:Humans; D019344:Lactic Acid / Q000097:blood; D009132:Muscles / Q000473:pathology; D012206:Rhabdomyolysis / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy
chemical_list: D019344:Lactic Acid
keywords: etiology; inherited myopathy; metabolic myopathy; rhabdomyolysis; symptoms