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Wednesday, October 21, 2020

Rhabdomyolysis – Causes, Symptoms, Treatment and Prevention

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Rhabdomyolysis is referred to as a condition in which skeletal muscle tissue dies and releases substances into the bloodstream, causing kidney failure.

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The condition is commonly caused by some specific factors that may include infections, overexertion, injury, or the use of some medications.

The condition is imaginably rare, with almost 26,000 new cases in the United States yearly. In most cases, passing fluid directly through veins is usually the first recommended step of treatment. Extreme symptoms may require blood filtration and kidney dialysis

What is rhabdomyolysis?

Rhabdomyolysis occurs when skeletal muscle tissues get damaged or die as a result of infection, trauma, or medication. These damaged components are then released in the bloodstream and filtered before leaving the body.

Many of these components can result in kidney damage, with protein pigment myoglobin being the most common. The complex tubing that occurs in the kidney can be blocked by myoglobin.

If the blockage persists or becomes severe, damage in the kidney could happen, and in worst cases, failure. Body fluids can also be retained by damaged muscle. This can result in dehydration and also reduce the inflow of blood to the kidney, hence, increasing the chances of organ failure.

Complications linked with Rhabdomyolysis depends on how severe the condition is, as well as other individual factors.

Less severe cases may not steer up any noticeable signs and might be detected using blood serum tests. Severe cases often cause extreme muscle pain, and can sometimes be life-threatening.

Causes

Most obvious cases of rhabdomyolysis are categorized as a part of crush syndrome. This is a condition that develops as the result of a skeletal muscle injury caused by trauma.

Typically, anything that leads to muscle injury, kidney injury, or dehydration can increase a person’s chance of developing rhabdomyolysis.

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Several cases that aren’t caused by direct trauma are examined to be the result of many factors. Medical experts and scientists are still exploring the full effects of the factors that may trigger the risk of rhabdomyolysis. Presently, rhabdomyolysis cases are classified as one o the following;

  • The result of external injury, substances, or infection
  • Inherited
  • Genetic conditions like muscular myopathies

Other recognized factors that can cause rhabdomyolysis include the following;

  • Traumatic damage to skeletal muscle tissues
  • Inability to move over a long period
  • Muscle sprain
  • Metabolic myopathies, which is known as hereditary muscle disorders
  • Severe burns that can cause damage to muscle
  • Heatstroke
  • Infections, in particular, viral and bacterial infections that can cause blood infections
  • Kidney disorders or diseases
  • Sickle cell anemia
  • Electrolyte disorder, like those affecting calcium and potassium
  • Weight-loss and dietary supplements, especially those that contain creative and ephedra
  • Inflammatory muscle conditions
  • Stroke or heart attack, which may result in muscle injury or stiffness
  • An endocrine disorder, such as hyperthyroidism and hypothyroidism
  • Cardiac or vascular surgery, which may often lead to muscle damage

Exposure to toxins, such as long-term or excessive exposure to alcohol or drug use, could also cause rhabdomyolysis.

This also includes exposure to toxins gotten from the environment, including molds, insect or reptile venom, and carbon monoxide. Rhabdomyolysis could also occur as a result of certain medications.

Symptoms of rhabdomyolysis

Although mild cases of rhabdomyolysis may not cause noticeable symptoms, most people with the condition experience a standard set of complaints.

Most symptoms manifest themselves within hours to days after the rhabdomyolysis develops or a cause has occurred.

Early symptoms of rhabdomyolysis may include:

  • Muscle weakness
  • Inflammation
  • Muscle pain
  • Overall exhaustion or fatigue
  • Dark-colored urine (cola or tea looking)
  • Irregular heartbeat
  • Nausea and vomiting
  • Disorientation or confusion
  • Dizziness and fainting spells

You should seek immediate medical attention if you notice any of these symptoms. If left untreated can become life-threatening, especially if the kidney starts to fail.

Diagnosis

Most medical doctors may begin by reviewing medical histories of patients and considering factors such as injury, medication use, overexertion, and other health complications or symptoms.

Laboratory confirmation is generally required to affirm diagnosis. This commonly entails the detection of elevated CK (Creatine Kinase) levels in the blood, as well as the presence of myoglobin in patient’s urine. CK levels that are approximately five times more than the normal levels are clear evidence of rhabdomyolysis.

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Although the definition of a healthy level of CK varies by race, sex , and ethnicity. It is important to note that physical exertion or stressful activities may elevate CK levels temporarily. This means that tests should be carried out roughly after seven days of avoiding rigorous activities.

Muscle biopsies are carried out as well. This is done to determine muscle damage. Genetic testing can also be done to look for the presence of inherited muscle complications or conditions.

Once these tests are done, and rhabdomyolysis is confirmed, then treated can commence, thereby minimizing the symptoms and the chances of the condition returning.

Treatment

The treatment of rhabdomyolysis depends on how severe the symptoms, case, and presence of additional health issues that may elevate the risk of kidney damage or failure. In extreme cases, without immediate attention, kidney damage can be irreversible.

One treatment method of rhabdomyolysis is “intravenous fluid therapy.” This is done by administrating plenty of water into the veins for a long time to help rehydrate the body enough to flush out any myoglobin.

Using other treatment options may include;

  • Dialysis
  • Urine alkalization
  • Filtering of blood (in extreme cases)

Prevention

The quickest way to prevent rhabdomyolysis is to stay hydrated, avoid long periods of immobilization, and engage in exercises, but ensure it’s within healthy limits.

Other common ways to help prevent rhabdomyolysis include:

  • Avoid gaining muscles, avoid weight-loss, and stay away from performance-enhancing supplements, especially the ones that contain ephedrine, creatine, ephedra
  • Avoid high level of caffeinated drinks
  • Seek professional training advice if you’re engaging in any significant physical event (marathons, cycling, etc)
  • Monitor your body language and know when not to go beyond work-out limits
  • Get immediate medical attention as soon as you notice something isn’t right

Have you ever had to treat rhabdomyolysis? What were the symptoms you noticed? Any thoughts on the subject? Share with us in the comments below.

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Disclaimer: This article is purely informative & educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.

Oluwafemi Michael
Oluwafemi Michael is an online Mental Health Therapist, Advocate for Mental Health Awareness, a programmer, and also a content creator from Edo state, Akoko-Edo LG.
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