Myoglobinuria diagnostic study of choice: Difference between revisions
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Revision as of 10:10, 27 July 2018
The most important laboratory test is creatine kinase (CK) levels to assess for rhabdomyolysis.
Myoglobin is the first enzyme to increase, but it returns to normal levels within 24 hours after the onset of symptoms. The reason is that myoglobin is rapidly cleared by the kidneys from the serum into the urine. Serum CK levels may remain elevated after serum and urine test results for myoglobin have become negative. CK levels typically peak {1000 U/L) about 3 days after the onset of symptoms, and remain elevated for several days. [1]
Acute renal insufficiency (elevated BUN and creatinine levels) is a sequel of severe myoglobinuria in which the globulin precipitates and blocks the urinary tubules. [2]
Although both myoglobinuria and hemoglobinuria may cause a tea-colored appearance of the urine, and both can cause positive results on the urine dipstick for blood, myoglobinuria can be differentiated from hemoglobinuria by performing the following:
- Myoglobinuria is brown, and only a few RBCs are present in the urine.
- Red or brown urine with a negative dipstick result for blood indicates a dye in the urine. [3]
References
- ↑ Lee G (2014). "Exercise-induced rhabdomyolysis". R I Med J (2013). 97 (11): 22–4. PMID 25365815.
- ↑ Khan FY (2009). "Rhabdomyolysis: a review of the literature". Neth J Med. 67 (9): 272–83. PMID 19841484.
- ↑ Chatzizisis YS, Misirli G, Hatzitolios AI, Giannoglou GD (2008). "The syndrome of rhabdomyolysis: complications and treatment". Eur J Intern Med. 19 (8): 568–74. doi:10.1016/j.ejim.2007.06.037. PMID 19046720.