Myoglobinuria diagnostic study of choice

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aksiniya Stevasarova, M.D.

Overview

Study of choice

• There is no single diagnostic study of choice for the diagnosis of [[myoglobinuria], but myoglobinuria can be diagnosed based on creatine kinase (CK) levels to assess for rhabdomyolysis.
• Myoglobin is first enzyme to increase in cases of rhabdomyolysis, but it returns to normal levels within up to 24 hours after the onset of symptoms, because it is rapidly cleared by the kidneys. Serum CK levels remain elevated after serum and urine test results for myoglobin have become negative. CK levels normally peak (1000 U/L) around 3 days after the onset of symptoms, and remain elevated for several days.

The comparison table for diagnostic studies of choice for [disease name]

	Sensitivity	Specificity
Creatine Kinase	100%	100%
Myoglobin	50%	50%

Diagnostic results

The following result of creatine kinase(CK) is confirmatory of myoglobinuria, caused my rhabdomyolysis:

• CK 1000 U/L

Sequence of Diagnostic Studies

The creatine kinase levels should be performed when:

• The patient presented with symptoms/signs of myalgia, muscle weakness, and dark urine as the first step of diagnosis.
• A positive creatine kinase level is detected in the patient, to confirm the diagnosis.

Diagnostic Criteria

• There are no established criteria for the diagnosis of [disease name].