Rhabdomyolysis Definition, Reason, Symptoms, Treatment & Prevention
Definition
Rhabdomyolysis is a condition where there is damage to muscle cells in large quantities and in a short time. This disease is quite rare. Data shows this condition can be experienced by 1 in 10,000 people who take statin drugs for a long time.
If left untreated, these damaged muscle cells can enter the bloodstream and damage the kidneys. In the long term, this damage will cause permanent kidney failure.
Rhabdomyolysis Symptoms
The three classic symptoms experienced in rhabdomyolysis are:
- Muscle pain in the shoulders, thighs or back
- Arm and leg muscle weakness
- Urine becomes scanty and dark red or brown.
Apart from these three typical symptoms, someone with rhabdomyolysis also often experiences:
- Abdominal pain
- Nauseous vomit
- Fever
- The heart rate increases
- Loss of consciousness, dehydration
However, in some cases a person with rhabdomyolysis does not experience muscle complaints at all.
Rhabdomyolysis Reason
The causes of rhabdomyolysis are divided into two, traumatic and non-traumatic. Traumatic causes such as:
- Accidents and crashes
- Pressure on the muscles due to prolonged bed rest eg prolonged hospitalization of an unconscious person
- Got electric shock
- Injuries caused by insect or snake bites
Meanwhile, non-traumatic causes include:
- Use of illegal drugs and alcohol
- Muscle injury from activity or exercise
- The use of statins in high doses and long-term
- High body temperature (hyperthermia) or heat stroke
- seizures
- Diabetic ketoacidosis
- Bacterial infection that spreads to the blood (sepsis)
- Viral infections such as flu, herpes and HIV
Diagnosis
To confirm the diagnosis of rhabdomyolysis, it is necessary to do a blood test to see the level of creatinine kinase, a by-product of muscle breakdown that is released into the blood.
In addition to creatinine kinase, damaged muscles will also release myoglobin into the urine. Therefore, urine examination to ensure the presence of myoglobin is no less important.
Even though not everyone with rhabdomyolysis shows positive results, this myoglobin examination must still be done.
Rhabdomyolysis Treatment
To treat rhabdomyolysis, a patient is generally admitted to the hospital to receive an infusion of fluids. This infusion aims to maintain urine production and prevent dehydration. In some cases, where there is a decrease in kidney function, therapy with dialysis or hemodialysis is also needed.
In addition, impaired kidney function caused by rhabdomyolysis also often causes electrolyte imbalances. In such cases, administration of additional electrolyte therapy such as potassium, sodium and phosphorus is also needed. Keeping blood electrolyte levels balanced is important to avoid disruption of the work of the heart and other important organs.
Although rare, dead muscle cells can put pressure on the surrounding tissue and result in suppression and impaired blood circulation. The resulting condition is called compartment syndrome. In effect, the surrounding tissue that gets less blood flow will be damaged and die. One way to treat it is by surgery which removes dead muscle cells so that blood flow returns smoothly.
If rhabdomyolysis is caused by other conditions, such as diabetes or thyroid hormone disorders, the underlying disease must also receive attention and be treated properly.
Complications
Electrolyte imbalance as a result of rhabdomyolysis can cause heart rhythm disturbances, cardiac arrest and kidney damage. In addition to the heart and kidneys, 1 in 4 rhabdomyolysis patients also has impaired liver function.
Compartment syndrome also has the potential to occur as a complication due to the suppression of damaged muscle cells to the surrounding tissue. As a result, the pressed tissue will be disrupted by its blood supply and nutrition and it is not impossible for widespread cell death to occur.
Prevention
Rhabdomyolysis can be prevented in various ways:
- Carry out strict control if you have a disease that can increase the risk of muscle damage such as diabetes and thyroid
- Just warm up before exercising
- Mobilization in patients who are bedridden for a long time
- Routine blood and urine tests on risky drug use such as statins.