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Rhabdomyolysis
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
Exertional rhabdomyolysis is common in teenagers due to the growing popularity of highly strenuous exercise regimens and increasing intensity in youth sports programs. Heavy weight lifting is particularly damaging especially in the unconditioned person exercising in high temperatures with some element of dehydration.
Physical activity and sickle cell disease
Published in Roy J. Shephard, Physical Activity and the Abdominal Viscera, 2017
Exertional rhabdomyolysis can develop in anyone who exercises at a high intensity relative to their physical condition. The release of myoglobin during the break down of muscle tissue causes an associated myoglobinuria. In 5-7% of cases, the ferrihaemate that is released from myoglobin in an acidic environment reaches a sufficient concentration to damage the renal tubules, leading to pro gressive renal failure.[99] Manifestations of renal damage include an increase in serum potassium that causes muscle weakness, abnormalities of cardiac rhythm and a possibility of cardiac arrest, and decreases of calcium ion concentrations that induce muscular tremors and weakness of cardiac contraction. Even if a fatal outcome can be avoided, prolonged dialysis is often needed until renal function recovers.[100]
Epidemiology of Exertional Rhabdomyolysis in the United States: Analysis of NEISS Database 2000 to 2019
Published in The Physician and Sportsmedicine, 2022
Barry P. Boden, David J. Isaacs, Anwar E. Ahmed, Scott A. Anderson
Exertional rhabdomyolysis (ER) is a condition caused by novel, repetitive, and strenuous exercise with a resultant breakdown of striated muscle fibers and release of muscle contents into the circulation [1–4]. The syndrome is characterized by malaise, myalgias (commonly the shoulder, thighs, lower back, and buttocks), weakness, limited active and passive range of motion, nausea, myoglobinuria (dark or tea-colored urine), and renal abnormalities [4,5]. Diagnosis is confirmed by documenting elevated muscle enzymes such as creatine kinase (CK), although there is no widely accepted threshold for diagnosis [4]. The condition varies from asymptomatic with elevated serum muscle enzymes [6] to complications such as metabolic acidosis, hyperkalemia, hypocalcemia, arrhythmia, acute kidney injury (AKI), compartment syndrome, and disseminated intravascular coagulation [7].
Black Race and Body Mass Index Are Risk Factors for Rhabdomyolysis and Acute Kidney Injury in Trauma
Published in Journal of Investigative Surgery, 2020
Areg Grigorian, Viktor Gabriel, Ninh T. Nguyen, Brian R. Smith, Sebastian Schubl, Boris Borazjani, Victor Joe, Jeffry Nahmias
An association between rhabdomyolysis and black race has previously been reported in the non-trauma setting. Exertional rhabdomyolysis was first described in military personnel in 1970 and later in high-performing athletes [27–30]. Several of these cases were attributed to sickle cell trait [29, 30], which is more prevalent in the black population (nearly 7% of African-Americans have sickle cell trait) [31]. This prompted a large military study of nearly 45,000 black soldiers, which demonstrated those with sickle cell trait had a nearly 55% higher risk for developing exertional rhabdomyolysis, even after controlling for BMI [8]. A subsequent study of nearly 1,100 US Army soldiers demonstrated that patients that self-reported to be of black race had a higher risk for development of rhabdomyolysis [9]. Our study confirms that black race is an independent risk factor for rhabdomyolysis in a large civilian trauma population.
Twelve cases of exertional rhabdomyolysis in college football players from the same institution over a 23-year span: a descriptive study
Published in The Physician and Sportsmedicine, 2018
Terry L. Thompson, Thomas X. Nguyen, Cina R. Karodeh
Exertional rhabdomyolysis [ER] is a rare form of rhabdomyolysis, but a well-known complication of extreme physical exertion [1]. Rhabdomyolysis is a syndrome resulting from the leakage of intracellular contents into the systemic circulation due to the breakdown of skeletal muscle [2]. Myoglobinuria and potentially life-threatening complications such as acute renal failure may also ensue as a result of rhabdomyolysis [2]. Furthermore, disseminated intravascular coagulation, compartment syndrome, severe hyperkalemia that may be associated with cardiac arrhythmias and even death may occur as a result of this syndrome [3,4]. The occurrence of ER is approximately 29.9 per 100,000 patient years [3]. Although uncommon, ER has been described in collegiate football players, swimmers, military recruits, and body builders [5–9]. Post-exercise laboratory evidence of ER has been described as creatine kinase levels 5–10 times greater than normal reference interval levels, although it is possible to reach much higher levels [9–13].