Rhabdomyolysis is characterized by the breakdown of skeletal muscle and the subsequent release of intracellular contents into the circulatory system. It is potentially life-threatening because it is sometimes associated with very high creatine kinase levels, myoglobinuria, and acute renal failure. We experienced a case of postoperative rhabdomyolysis after prolonged laparoscopic radical nephrectomy in the semi-lateral decubitus position. It was associated with suspicious gluteal compartment syndrome. Fortunately, the patient's renal function was normal through his hospital course. Rhabdomyolysis is well worth considering at the point of intraoperative positioning and postoperative care after prolonged surgery.
Acute Kidney Injury ; Compartment Syndromes ; Creatine Kinase ; Muscle, Skeletal ; Myoglobinuria ; Nephrectomy* ; Postoperative Care ; Rhabdomyolysis*

In this article, I review various causes of exogenous myoglobinuria(MU) and its pathogenesis in 26 consecutive patients admitted to emergency room, Asan Medical Center and determine whether there is a relationship between concentration of urine myoglobin(Mb) and acute renal failure(ARF) as a complication of MU. Serum and urine Mb were measured by RIA using myoglobin kit (Daiichi, Inc., Tokyo, Japan). The most common disorder of MU was septic shock with hypotension, followed by crush syndrome, major arterial occlusion by thormbosis, alcohol intoxication with status epilepticus, intoxication of unidentified snake venom and drug ingestion. On the basis of this limited amount of data, there is a significant association between high concentration in urine Mb(> 300 ng/ml) and ARF(Fisher's exact test, p< 0.005). To minimize the chances of development of ARF, routine urine Mb levels should be checked on patients at risk, especially septic shock with hypotension.
Adult ; Aged ; Female ; Human ; Kidney Failure, Acute/complications ; Male ; Middle Age ; Myoglobinuria/complications/*etiology ; Retrospective Studies

We experienced a case of severe hyponatremia complicated by rhabdomyolysis in a schizophrenic patient who had been treated with clozapine and nemonapride. The exact cause of sudden hyponatremia was uncertain, however, the possibility of chronic polydipsia could not be ruled out. Electrolyte imbalance was corrected by isotonic saline infusion, and plasma sodium concentration returned to normal after 24 hours. However, the patient developed severe rhabdomyolysis with myoglobinuria and acute renal failure. After 18 days of treatment, patient's physical and mental condition stabilized without further complication. Possible contribution of clozapine in increasing the risk of rhabdomyolysis after the correction of hyponatremia was briefly discussed.
Acute Kidney Injury ; Clozapine* ; Humans ; Hyponatremia* ; Myoglobinuria ; Plasma ; Polydipsia ; Rhabdomyolysis* ; Sodium

The authors experienced a case of myoglobinuria accompanied by generalized myalgia and mild fever that developed 3 hours 30 minutes after general anesthesia. Tracheal intubation was done smoothly 5 minutes after injection of thiopental sodium(275 mg) and pancuronium bromide(6 mg), and anesthesia was maintained with ethrane/N2O/O2(1.5-2%/21/21/min). There was no specific event except tachycardia and fluctuation of blood pressure throughout operation. In this case, we assume that the myoglobinuria is a presentation of the sign of an abortive type of malignant hyperthermia. However, it was not confirmed. We had good patient outeome with the supportive measures of hydration and diuresis. The patient was discharged twenty three days after operation without any complication.
Anesthesia ; Anesthesia, General* ; Blood Pressure ; Diuresis ; Fever ; Humans ; Intubation ; Malignant Hyperthermia ; Myalgia ; Myoglobinuria* ; Pancuronium ; Tachycardia ; Thiopental

Mortality and morbidity of malignant hyperthermia has decreased markedly by the avoidance of succinylcholine, and the earlier detection and introduction of dantrolene. We report a fourteen-year-old boy who developed malignant hyperthermia during general anesthesia. He showed the earlier clinical signs, such as elevation of end-tidal CO2, tachycardia, and hypertension. After prompt administration of dantrolene, operation was continued with profopol and midazolam. Rhabdomyolysis and myoglobinuria followed, and were managed by hydration and alkalinization of urine. Azotemia did not occur, and he was discharged without any sequelae on the 10th postoperative day.
Anesthesia, General ; Azotemia ; Dantrolene ; Humans ; Hypertension ; Male ; Malignant Hyperthermia* ; Midazolam ; Mortality ; Myoglobinuria ; Rhabdomyolysis* ; Succinylcholine ; Tachycardia

A-67-year old man was hospitalized due to fever, cough and dyspnea upon exertion, and was treated with intravenous antibiotics. During the hospital course he presented with weakness in his low extremities. The laboratory tests showed an elevated CK level and myoglobinuria. He was diagnosed with rhabdomyolysis with community-acquired pneumonia and treated accordingly. Subsequently, his symptoms and signs of rhabdomyolysis improved.
Anti-Bacterial Agents ; Cough ; Creatine Kinase ; Dyspnea ; Extremities ; Fever ; Myoglobinuria ; Pneumonia* ; Rhabdomyolysis*

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging febrile illness. While many kinds of severe complications including acute renal failure have been reported, rhabdomyolysis is rarely reported in association with SFTS. A 54-year-old female farmer was admitted with fever and diffuse myalgia. Laboratory finding showed thrombocytopenia, leukopenia, azotemia, extremely elevated muscle enzyme levels and myoglobinuria. We describe a fatal case of rhabdomyolysis with acute renal failure complicated by SFTS.
Acute Kidney Injury ; Azotemia ; Farmers ; Female ; Fever* ; Humans ; Leukopenia ; Middle Aged ; Myalgia ; Myoglobinuria ; Rhabdomyolysis* ; Thrombocytopenia*

Compartment syndrome is rarely associated with non-traumatic rhabdomyolysis. We report the case of a 23-year-old man who developed compartment syndrome associated with rhabdomyolysis caused by prolonged immobilization after antidepressive drug overdose. Elevation of serum creatine phosphokinase and myoglobinuria indicated rhabdomyolysis. Painful swelling of the right buttock and thigh and right lower limb paralysis with sensory and motor deficit were suggestive of gluteal and thigh compartment syndrome with the complication of sciatic nerve injury. The patient received an immediate fasciotomy, medical treatment and rehabilitation. At five months after initial treatment, the patient could walk independently with nearly full recovery of his right lower limb function.
Buttocks ; Compartment Syndromes ; Creatine Kinase ; Drug Overdose ; Humans ; Immobilization ; Lower Extremity ; Myoglobinuria ; Paralysis ; Rhabdomyolysis ; Sciatic Nerve ; Thigh ; Young Adult

High-voltage electrical burns are associated with deep muscle injuries. A hidden, deep muscle injury has no specific clinical manifestations, and undetected muscle injury sometimes leads to septisemia or major amputations. From January to December 1996, 52 burned patients were admitted to the burn center. We evaluated their laboratory findings and the results of diagnostic tools. The items of study were urine, EKG, CK-MB, CPK, LDH, SGOT, SGPT, PYP scanning, Plethysmography, and arteriography. The presence of myoglobinuria and the increase in SGOT and SGPT two weeks after the injury were related to the extent of the burns. The PYP scanning was a very sensitive and useful tool for detecting hidden muscle injuries. The arteriographic findings were unsatisfactory for deciding the amputation level. The PCR findings converting to obstructive type were helpful in predicting possibile amputations.
Alanine Transaminase ; Amputation ; Angiography ; Aspartate Aminotransferases ; Burn Units ; Burns* ; Electrocardiography ; Humans ; Myoglobinuria ; Plethysmography* ; Polymerase Chain Reaction ; Radionuclide Imaging*

von Hippel-Lindau (VHL) disease is an inherited syndrome manifesting with benign and malignant tumors. Deficiency of carnitine palmitoyltransferase type II (CPT2) is a disorder of lipid metabolism that, in the muscle form, manifests with recurrent attacks of myalgias often associated with myoglobinuria. Rhabdomyolytic episodes may be complicated by life-threatening events, including acute renal failure (ARF). We report on a male patient who was tested, at 10 years of age, for VHL disease because of family history of VHL. He was diagnosed with VHL but without VHL-related manifestation at the time of diagnosis. During childhood, the patient was hospitalized several times for diffuse muscular pain, muscle weakness, and dark urine. These recurrent attacks of rhabdomyolysis were never accompanied by ARF. The patient was found to be homozygous for the mutation p.S113L of the CPT2 gene. To the best of our knowledge, this is the first report of the coexistence of VHL disease and CPT2 deficiency in the same individual. Based on findings from animal models, the case illustrates that mutations in the VHL gene might protect against renal damage caused by CPT2 gene mutations.
Acute Kidney Injury ; Carnitine O-Palmitoyltransferase ; Diagnosis ; Humans ; Lipid Metabolism ; Male ; Models, Animal ; Myalgia ; Myoglobinuria ; Rhabdomyolysis ; von Hippel-Lindau Disease