What is it about ?
Rhabdomyolysis is a massive and acute destruction of muscle tissue. It is the striated muscle cells that are affected: these are the muscles that are used to move the skeleton. The wall of the muscle cell is damaged, which no longer allows the muscle to function normally. Substances normally present in muscle are also released: creatinine kinase or CK.
Due to the release of all kinds of degradation products, the kidneys can be damaged and a renal failure can develop. Early treatment is needed to prevent this disease from taking hold.
The causes
The possible causes of massive breakdown of muscle tissue are as follows, listed in order of frequency:
- the patient is lying down for a long time, unconscious, on a hard surface;
- this situation may be due to alcohol or drug poisoning, or even to an illness.
- The prolonged pressure will damage the muscles.
- muscle crush trauma;
- excessive muscle tone, eg due to overtraining, too intense jogging, too much weight training;
- convulsions, eg in epilepsy;
- the use of alcohol or drugs, such as heroin or cocaine;
- certain drugs;
- Cholesterol lowering drugs (statins) can also cause rhabdomyolysis, although this is rare.
- These drugs often cause muscle pain, but it does not mean rhabdomyolysis.
- high body temperature, e.g. in heat-related illnesses;
- metabolic disorders, eg abnormally low blood potassium levels (hypocalcaemia);
- infections;
- muscle diseases (myopathies).
How to recognize it?
If you have rhabdomyolysis, you have the following symptoms:
- pain, swelling, pain or tenderness on palpation in the affected area (limbs, back, buttocks);
- fainting, confusion and dehydration, with or without fever;
- paralysis or sensory disturbances in the limbs;
- dark urine, little or no urine output.
How can the doctor recognize it?
Interrogation and clinical examination
The doctor will ask you questions about your symptoms and their circumstances, and then perform a physical examination.
Other examinations
He will also have a blood test to measure kidney function and creatinine kinase concentration. In the case of rhabdomyolysis, this concentration quickly rises to over 10,000.
Sometimes the doctor will perform a urine analysis. A urine test strip may indicate blood in the urine, but red blood cells cannot be seen under a microscope. This blood comes from the breakdown of muscle tissue and is very similar to the hemoglobin in red blood cells.
What can you do ?
- Try to avoid the following:
- excessive consumption of alcohol ;
- taking drugs such as heroin or cocaine;
- excessive sports activities, especially too intense sprints and weight training sessions with too heavy weights.
- If you are often alone and are at risk of falling, try to organize an alert system so that we can come and help you quickly. You can get it through your mutual.
- If you are ill, contact the doctor.
- Drink enough when you exercise, this reduces the risk of rhabdomyolysis.
- If needed, drink special energy drinks to compensate for the loss of salt. Do this in case of intensive effort of more than 30 minutes.
- Energy drinks are isotonic drinks. This means that they contain added salts and sugars, allowing better absorption of liquids.
- If there are signs of massive breakdown of muscle tissue, see a doctor immediately to have your blood and urine tested.
What can your doctor do?
Hospital treatments
Usually, if you have rhabdomyolysis, you will need to be hospitalized.
- First aid consists of compensatory rehydration (physiological water) by infusion to prevent kidney failure from developing.
- If you stop passing urine, you may need to dialyze.
- In some cases it is necessary toincise the membranes around the muscles to reduce the pressure on the muscles. This should be done if the muscle tissue threatens to necrode (die) from the excessive pressure exerted, or if there is a risk of nerve damage.
Prognosis
The prognosis for rhabdomyolysis is good, even in the presence of renal failure. The affection is indeed reversible.
Compartment syndrome should always be treated quickly to avoid permanent damage to nerves and muscles.
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