Dr. Witte, Ph.D., PA-C
Exertional rhabdomyolysis (ER) is a severe condition of myocyte damage after engaging in physical activity. The muscle cell injury leads to cell membrane breakdown, decreasing muscle cell functionality. Myalgias, muscle weakness, and cola-colored urine characterize the signs and symptoms of this condition, although there are variations within the presentation. Identifying this disease process is vital because edema, intravascular volume depletion, electrolyte disturbances, enzymatic abnormalities, and myoglobinuria resulting from muscle cell injury can result in severe side effects. These sequelae include acute kidney injury (AKI), compartment syndrome, and death. For diagnosis, the serum creatine kinase (CK) levels are five times the upper limit of normal or > 1000 IU/L. Patients have a history of various exertional activities revolving around endurance sports, such as triathlons, intense military training, high-intensity interval training, weightlifting, and organized sports, among the common ones reported. The common risk factors noted are deconditioned states, viral infections, drug and alcohol abuse, exercise in hot environments, and genetic polymorphism (eg, sickle cell and McArdle disease). Given the severity of the illness, hospitalization with subsequent intravenous hydration is often required to treat this disease. The prognosis is generally good in patients who receive early diagnosis and treatment. This review provides an appraisal of the currently available literature to annotate the etiology, pathophysiology, clinical presentation, and treatment of ER to facilitate prompt diagnosis to prevent disease sequela.
Coletti J. HyperCKemia with a History of Exercise: Consider Exertional Rhabdomyolysis. Lynchburg Journal of Medical Science. 2023; 5(1).
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