Rhabdomyolysis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
Overview
The aetiological spectrum of rhabdomyolysis is extensive in many cases, multiple muscle insults are usually needed to produce rhabdomyolysis unless an underlying myopathy is present. The most common causes of rhabdomyolysis in adults are illicit drugs, alcohol abuse, medication, muscle diseases, trauma, neuroleptic malignant syndrome (NMS), seizures and immobility, Whereas in paediatric patients, the most common causes are viral myositis, trauma, connective tissue disorders, exercise, and drug overdose.[1]
Causes
Life-Threatening Causes
- Burns
- Crush injury
- Electrical injury
- Exertional Heat stroke
- Compartmental syndrome
- Malignant hyperthermia
- Neuroleptic malignant syndrome
- Electrolyte abnormalities such as Hypokalemia
Common Causes
- Burns
- crush injury
- Long-lasting muscle compression in Coma patients, under the influence of alcohol, medication or illicit drugs
- Electrical injury
- Snake venom
- Heat stroke
- Seizures
Causes by Pathophysiology
Rhadomyolysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Traumatic or Muscle Compression | Non - Traumatic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Non-Traumatic Exertional | Non-Traumatic Non-Exertional | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Non - Traumatic Exertional Rhadomyolysis in a Normal Muscle | Non - Traumatic Exertional Rhadomyolysis in an Abnormal Muscle | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
❑ Crush injury ❑ Coma ❑ Post ictal state ❑ Post - Operative Surgical trauma ❑ Electrical Injury ❑ Compartment Syndrome ❑ Immobilizaion | ❑ Exertional Heat Stroke ❑ Sickle cell trait ❑ Hyperkinetic States Such as * Grand mal Seizures * Delirium tremens * Psychotic agitation * Amphetamine Overdose | ❑ Metabolic myopathies ❑ Mitochondrial myopathies ❑ Malignant hyperthermia ❑ Neuroleptic malignant syndrome | ❑ Drugs and toxins ❑ Infections ❑ Electrolyte abnormalities ❑ Endocrinopathies ❑ Inflammatory myopathies ❑ Miscellaneous | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Non-Traumatic Non-Exertional Causes | |
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Infections
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Viral infections : Adenovirus, Coxsackievirus, Cytomegalovirus, Echovirus , Epstein-Barr , Herpes simplex, Human immunodeficiency virus, Influenza A and B, Parainfluenza Bacterial infections : Bacterial pyomyositis, Coxiella burnetii(Q fever), E. coli, Ehrlichiosis,Falciparum malaria, Legionella, Leptospirosis, Mycoplasma pneumoniae, Salmonella, Staphylococcal infection, Streptococcus, Tularemia |
Electrolyte abnormalities
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Hypokalemia, Hypophosphatemia |
Endocrinopathies
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Hypothyroidism, Diabetic ketoacidosis , Non-ketotic hyperglycemia |
Inflammatory myopathies
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Dermatomyositis, Polymyositis |
Miscellaneous
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Alcoholism, Baclofen withdrawl, Capillary leak syndrome, Status asthmaticus |
References
- ↑ Khan FY (2009) Rhabdomyolysis: a review of the literature. Neth J Med 67 (9):272-83. PMID: 19841484