Rhabdomyolysis is a serious, acute condition that results from rapid death of muscle tissue. When muscles are damaged through trauma, drug toxicity, disease, or other causes, the cells release their contents into the blood stream. When the kidneys are unable remove this waste quickly enough, renal (kidney) failure may result. In rare cases, rhabdomyolysis can even cause death. Prompt treatment is imperative to avoid this outcome.

In rare cases, patients experiencing severe, acute-onset of dermatomyositis, polymyositis, or necrotizing myopathy may suffer rhabdomyolysis. The muscle symptoms that occur as a side effect of statin medications can also cause this complication, especially when taken in high doses.

Symptoms

Three symptoms are a classic indication of rhabdomyolysis. These include muscle pain, especially in the shoulders, thighs, or lower back, muscle weakness, and dark red or brown urine (the color of tea) or decreased urine production. However, half of people with rhabdomyolysis may have no muscle-related symptoms.

Patients may also experience abdominal pain, nausea and vomiting, fever, rapid heart rate, confusion, dehydration, or loss of consciousness.

Diagnosis

Creatine kinase is a product of muscle breakdown. Levels of this enzyme in the blood will be elevated, sometimes greater than 5,000 u/l. There may also be blood in the urine.

Treatment

Early diagnosis and treatment of rhabdomyolysis and its cause is the key to a successful outcome. This is a medical emergency and must be treated in a hospital setting. Treatment usually includes infusion of large volumes of intravenous fluids, correction of electrolyte imbalances, and monitoring for other organ complications. Occasionally kidney dialysis is necessary.