Rhabdomyolysis laboratory findings: Difference between revisions

Jump to navigation Jump to search
 
Line 4: Line 4:


==Laboratory Findings==
==Laboratory Findings==
* '''Urinalysis'''
** Blood (+)
** No red blood cells on microscopy.  This situation is either hemoglobin in the urine or myoglobin.  The serum will be pink with hemoglobinuria.
* '''Serum Markers'''
** Elevated serum creatinine kinase
*** CK elevation: Generally accepted > 5 times normal.  Corresponds to about 200g of muscle. 
*** Begins to rise 2-12 hrs after onset.  Peaks 1-3 days in.  Declines 3-5 days after the process stops.
** Myoglobin
*** Myoglobin: Starts earlier than CK but clears faster, so serum and urine myoglobin useful early in course of the disease.  Myoglobin is eventually urinated and/or converted to bilirubin.
*** All myoglobinuria is caused by rhabdomyolysis, but not all rhabdomyolysis causes myoglobinuria. Urine changes color when > 1mg/ml.
** LDH (lactic dehydrogenase)


Approach to the Evaluation of Rhabdomyolysis
The approach to the evaluation of rhabdomyolysis is as follows:
* Minimum Evaluation
* '''Minimum Evaluation'''
** Etiology certain:
** Etiology certain:
*** CBC (complete blood count)
*** CBC (complete blood count)
Line 25: Line 14:
*** Urine pH
*** Urine pH
** Consider looking for [[hypothyroidism]] and sickle cell trait.
** Consider looking for [[hypothyroidism]] and sickle cell trait.
* Extensive Evaluation:  
* '''Extensive Evaluation:'''
** If etiology is uncertain, can check:  
** If etiology is uncertain, the following labs can be checked:  
*** [[Thyroid stimulating hormone]]
*** [[Thyroid stimulating hormone]]
*** Erythrocyte glycolytic enzymes
*** Erythrocyte glycolytic enzymes
Line 32: Line 21:
*** Serum [[carnitine]]  
*** Serum [[carnitine]]  
*** Organic acids in urine.
*** Organic acids in urine.
* '''Urinalysis'''
** Blood (+)
** No red blood cells on microscopy.  This situation is either hemoglobin in the urine or myoglobin.  The serum will be pink with hemoglobinuria.
* '''Serum Markers'''
** Elevated serum creatinine kinase
*** CK elevation: Generally accepted > 5 times normal.  Corresponds to about 200g of muscle. 
*** Begins to rise 2-12 hrs after onset.  Peaks 1-3 days in.  Declines 3-5 days after the process stops.
** [[Myoglobin]]
*** Myoglobin: Starts earlier than CK but clears faster, so serum and urine myoglobin useful early in course of the disease.  Myoglobin is eventually urinated and/or converted to [[bilirubin]].
*** All myoglobinuria is caused by rhabdomyolysis, but not all rhabdomyolysis causes myoglobinuria. Urine changes color when > 1mg/ml.
** LDH ([[lactic dehydrogenase]])


==References==
==References==

Latest revision as of 14:31, 22 April 2013

Rhabdomyolysis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Rhabdomyolysis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Rhabdomyolysis laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Rhabdomyolysis laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Rhabdomyolysis laboratory findings

CDC on Rhabdomyolysis laboratory findings

Rhabdomyolysis laboratory findings in the news

Blogs on Rhabdomyolysis laboratory findings

Directions to Hospitals Treating Rhabdomyolysis

Risk calculators and risk factors for Rhabdomyolysis laboratory findings

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory Findings

The approach to the evaluation of rhabdomyolysis is as follows:

  • Minimum Evaluation
    • Etiology certain:
      • CBC (complete blood count)
      • CK
      • Chemistries
      • Liver function tests
      • Urine pH
    • Consider looking for hypothyroidism and sickle cell trait.
  • Extensive Evaluation:
    • If etiology is uncertain, the following labs can be checked:
  • Urinalysis
    • Blood (+)
    • No red blood cells on microscopy. This situation is either hemoglobin in the urine or myoglobin. The serum will be pink with hemoglobinuria.
  • Serum Markers
    • Elevated serum creatinine kinase
      • CK elevation: Generally accepted > 5 times normal. Corresponds to about 200g of muscle.
      • Begins to rise 2-12 hrs after onset. Peaks 1-3 days in. Declines 3-5 days after the process stops.
    • Myoglobin
      • Myoglobin: Starts earlier than CK but clears faster, so serum and urine myoglobin useful early in course of the disease. Myoglobin is eventually urinated and/or converted to bilirubin.
      • All myoglobinuria is caused by rhabdomyolysis, but not all rhabdomyolysis causes myoglobinuria. Urine changes color when > 1mg/ml.
    • LDH (lactic dehydrogenase)

References

Template:WH Template:WS