1. Rhabdomyolysis W. Rose

2. Rhabdomyolysis W. Rose 2015 Condition in which muscle cells die and release intracellular contents into the systemic circulation. Often associated with severe or intense exercise. Symptoms: Myalgia (muscle soreness), muscle weakness, and brown or ‘‘tea-colored’’ urine. Recent history of excessive exercise increases the clinical suspicion of rhabdo. Use of statin drugs (HMG-coA-reductase inhibitors) can also increase risk of rhabdo.

3. Rhabdomyolysis Manifestations: range from asymptomatic elevation of muscle enzymes in serum (mild) to extremely high enzyme levels and life-threatening electrolyte imbalances and acute renal failure. Incidence: 1.8 cases per 100,000 people per year (i.e. rhabdo is rare)

4. Rhabdomyolysis Laboratory findings: elevated serum creatine kinase (CK) and myoglobinuria confirm the diagnosis of rhabdomyolysis. Care: urine alkalinization*, aggressive intravenous fluids, and in some cases, short-term dialysis. *Intravenous D5W** with added NaHCO 3. The bicarb increases serum pH. ** 5% dextrose in water: an isotonic (278 mM) sugar solution.

5. Rhabdomyolysis As many as 15% of adult Americans taking lipid-lowering drugs (mostly HMG-coA reductase inhibitors, i.e. statins). Statins appear to cause a small increase in risk of rhabdo.

6. Sources Line RL, Rust GS. Acute exertional rhabdomyolysis. Am Fam Physician. 1995; 52(2): 502–6. Mendes P, Games Robles P, Mathur S. Statin-induced rhabdomyolysis: a comprehensive review of case reports. Physiotherapy Canada 2014; 66(2): 124-132. Sauret JM, Marinides G, Wang GK. Rhabdomyolysis. Am Fam Physician. 2002; 65(5): 907-12.