Rhabdomyolysis

Topic Overview

What is rhabdomyolysis?

Rhabdomyolysis (say "rab-doh-my-AH-luh-suss") is a rare but serious muscle problem. When you have it, your muscle cells break down, or dissolve. The contents of those cells leak into the blood. When it's in the blood, that material can travel to various parts of the body and cause problems.

If left untreated, this condition can be life-threatening. But when it's treated right away, most people make a full recovery.

What causes rhabdomyolysis?

Rhabdomyolysis can be caused by a variety of problems, such as:

• Severe muscle injury. This might be caused by prolonged pressure on muscle tissue, heat exhaustion, extreme physical exertion, seizures, or electrical burns.
• Medicines. Medicines that can cause this problem include:
  • Statins. These are medicines used to treat high cholesterol.
  • Salicylate. This is a form of aspirin that is found in Pepto-Bismol. It's also in some medicines used to reduce fever, pain, and inflammation such as in arthritis.
  • Gemfibrozil. This is a medicine used to treat high cholesterol.
  • Phenothiazine. This is used to treat certain psychiatric problems. It may also be used to treat severe nausea and vomiting.
  • Corticosteroids. This is a group of medicines used to treat or prevent inflammation.
  • Phenytoin. This is used to prevent and control seizures.
• Toxins. Toxins are substances that are poisonous, such as alcohol, cocaine, hornet stings, snakebite, and carbon monoxide.
• Certain infections. This includes salmonella, the flu, Legionnaires' disease, and some blood infections.

What are the symptoms?

Early symptoms are often hard to notice. Symptoms include:

• Weak muscles.
• Pain.
• Stiffness.
• Fever.
• Nausea.
• Dark-colored urine.

How is rhabdomyolysis diagnosed?

Your doctor will ask questions about your symptoms and past health and do a physical exam. The diagnosis is confirmed with blood and urine tests.

How is it treated?

Most people need to be treated in the hospital. If possible, the doctor will stop the cause of muscle cell death. The doctor will take steps to protect your organs. You may have to stop taking certain medicines if they are the cause of the problem.

You will also get treatment to help the kidneys remove the toxins from your blood. This includes getting plenty of fluids. You may get fluids through a vein (by IV). If your kidneys are badly damaged, you may also need dialysis.

How can you prevent it from coming back?

• Follow your doctor's advice to stop taking any medicines that may have helped cause the problem.
• Fluids help your kidneys filter out substances that can cause problems. Make sure you're getting enough fluids, especially:
  • After strenuous exercise.
  • After any condition that may have damaged your skeletal muscles. These are muscles that help you move, walk, and lift.

If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.