genitourinary disorders
Rhabdomyolysis
Symptoms and Signs of Rhabdomyolysis
The classic triad of symptoms in rhabdomyolysis is muscle pain, weakness, and reddish-brown urine. However, this trio of symptoms is present in fewer than 10% of all patients with rhabdomyolysis. Clinical presentation is variable, and many patients have no muscle complaints at all. When present, muscle pain affects proximal muscle groups, such as shoulders, thighs, lower back, and calves. At a high concentration, myoglobin excreted into the urine changes its color to red or brown and can be assessed with a dipstick analysis positive for blood (caused by myoglobinuria). However, due to rapid excretion of myoglobin, rhabdomyolysis cannot be excluded in the absence of myoglobinuria or urine discoloration. Other signs and symptoms vary based on the inciting event and complications (eg, fever is present in patients with infection and altered mental status in cases of intoxication). Acute kidney injury is reported in 15 to 50% of rhabdomyolysis complications ( Symptoms and signs reference ), and is higher in patients with concurrent dehydration, sepsis, and creatine kinase level over 15,000 IU/L (250 mckat/L). 1.Chavez LO, Leon M, Einav S, et al: Beyond muscle destruction: A systematic review of rhabdomyolysis for clinical practice.Crit Care20(1):135, 2016. doi: 10.1186/s13054-016-1314-5 