Rhabdomyolysis
Introduction
In normal conditions, muscles grow when certain activities cause the muscle fibers to become damaged and then subsequently regrown and developed through a series of cellular process. This activity occurs during the body is at rest. In other words, the continuous breakdown is normal for growing muscles as it allows them to become bigger through the introduction of myrofibrils, or muscle fibers.
However, there is a condition when the muscle fibers break down rapidly due to a number of reasons, and then they do not regrow at a corresponding rate. This condition is known in medical circles as rhabdomyolysis, which is derived from the words rhabdo- meaning rodlike, myo- which means muscle, and lysis which means rupture. Therefor the name of the disease literally means breakdown of skeletal muscle tissue (Wright 2). This disease could potentially be seen as hazardous because the broken muscle tissues can introduce intracellular substances into the bloodstream, particularly myoglobin protein.
Body Organs Affected By the Disease
Based on the literal translation of the name of the disease (skeletal muscle tissue breakdown), it can be inferred that the main organs affected by the disease are the muscle tissues, particularly the skeletal muscle tissues. Aside from skeletal muscle tissues, the kidneys appear to be affected by the disease as well. Myoglobinuria occurs when the myogoblin proteins that are released when the muscle fibers are broken down are released into the bloodstream, thus forcing the kidneys to work extra hard in filtering this excess protein in order to keep the blood clean. When myoglobin is accumulated in the kidneys, it can potentially block the renal path which can cause the kidney organs to deteriorate, and in extreme cases, lead to kidney failure.
Rhabdomyolysis Etiology
There are many causes of rhabdomyolysis. For example, trauma resulting from crush injuries can result in the muscle fibers becoming physically damaged, and thus rhabdomyolysis can occur. Other possible causes can include factors such as overexertion due to physical activity, and any activity that can induce a high temperature within the body such as lightning strikes and third-degree burns.
Rhabdomyolysis can also be caused by certain disorders such as muscular dystrophy, diabetic ketoacidosis, carnitine deficiency, and the like. It can also be due to infection caused by bacteria, viruses, or snake bites. Finally, certain medications and substances can cause the skeletal muscles to become disintegrated such as statins, LSD, ecstasy, and some amphetamines (Marchione).
Typical Persons Afflicted with the Disease
Generally, people of any age can develop rhabdomyolysis but there are some people who are more susceptible to it than the others. As seen in the symptoms described above, it can be inferred that the people who are more likely to have the disease are the ones who overexert in training, as well as the ones who have a history of diseases such as muscular dystrophy, diabetic ketoacidosis, and creatine deficiency. In addition, people who partake in the substances that are likely to cause the condition are also the ones that can develop the disease. Therefore, it can be said that people who possess one or two of the traits above are the ones most typical to have rhabdomyolysis.
Symptoms of Rhabdomyolysis
There are a number of symptoms that can be manifested when a person has rhabdomyolysis. Some of these include: muscle tenderness, stiffness and overall weakness, decreased urine output, and a dark red or brown urine. Patients may also experience seizures, overall fatigue, aching in the joints, and unexpected weight gain (“Rhabdomyolysis”).
The muscle aching, tenderness, and weaknesses can be explained by the general breakdown of the muscle fibers, causing them to become weaker. As mentioned above, the rate of muscle degeneration in rhabdomyolysis is considerably faster than regeneration, and so the net result is a weaker muscular system than before. The myoglobins are being deposited into the bloodstream rather than performing their job which is to deliver oxygen and other necessary nutrients for muscle growth.
On the other hand, the symptoms in urine can be traced by the effect of the disease on the kidneys. The decrease in urine output is attributed to the presence and obstruction of myoglobin along the renal paths thereby restricting typical kidney functions. Moreover, the characteristic dark brown color is due to the presence of myoglobin proteins in the urine, as well as the decreased water concentration due to the blockage of the renal tubes in the kidney.
Aside from these main symptoms, there are the other symptoms described above such as weakness and joint pains. These are the effects of the general body weaknesses which results from having the muscles and the kidneys being affected by the disease. However, these symptoms, unlike the main ones, are variable from person to person.
Aside from the symptoms, various tests can be conducted to ascertain if a person suffers from rhabdomyolysis. Some of these tests include urine tests in which a urine sample is tested for presence of myoglobin, and blood tests in which haemoglobin is tested for presence of some enzymes such as creatine phosphokinase (CK), SGOT, SGPT and LDH). Presence of myoglobin in the urine sample and/or detection of these enzymes which are involved in muscle decomposition are signs that a person has the disease (Nabili).
Treatment and Prognosis
If rhabdomyolysis is detected, the first thing to do is to determine the cause of muscle decomposition and then proceed to treat it. For example, electrolytes can be introduced or a deeper underlying disease that affects the muscle should be taken of first (Marchione). The damage to the kidneys should also be addressed; if the disease is treated soon enough, then the kidneys are less likely to be damaged irreparably (“Rhabdomyolysis”).
The prognosis of the diseases depends on how severe the disease was before it was detected and treated. If the treatment was made shortly after the detection, then the damage it has caused can be taken care of in a few weeks or months. However, if the treatment was made at later stages, the patient can still suffer from the consequences the disease has on the kidneys.
Prevention
Because of the adverse consequences rhabdomyolysis has on the body, perhaps it would be best if the disease was prevented in the first place. In order to stop the disease from occurring, it is recommended that certain lifestyle changes be implemented, like eating healthy foods in proper amounts do that the nutrition needs of the muscles are met, as well as avoidance of work that requires very heavy physical activity. Hydrating properly and preventing heat exhaustion can also contribute significantly to the prevention of the disease (Muscal).
Works Cited
Marchione, Victor. "Rhabdomyolysis Is a Kidney Damage Risk, Causes Muscle Injury, Weakness, and Abdominal Pain." Bel Marra Health. 11 Apr. 2016. Web. 12 Apr. 2016. <http://www.belmarrahealth.com/rhabdomyolysis-is-a-kidney-damage-risk-causes-muscle-injury-weakness-and-abdominal-pain/>. This article discusses rhabdomyolysis in layman's terms. Therefore, it is recommended to get a general overview of the disease.
Muscal, Eyal. "Rhabdomyolysis." Medscape. WebMD LLC, 22 June 2015. Web. 12 Apr. 2016. <http://emedicine.medscape.com/article/1007814-overview>. This website contains a comprehensive discussion of the disease, with a technical and formal tone which is suited for professionals.
Nabili, Siamak N. "Rhabdomyolysis." MedicineNet.com. MedicineNet Inc. Web. 12 Apr. 2016. <http://www.medicinenet.com/rhabdomyolysis/page4.htm>. The article, while comprehensive, can get too technical on some parts. Also, some parts must be clicked on to continue reading which can be an annoyance.
"Rhabdomyolysis." MedLine Plus. ADAM Health Solutions. Web. 12 Apr. 2016. <https://www.nlm.nih.gov/medlineplus/ency/article/000473.htm>. This article presents a brief yet detailed facts about the disease, which is helpful if one wishes to get the facts at a glance.
Wright, Will. "Rhabdomyolysis Revisited." CrossFit Journal. CrossFit, Inc., June 2011. Web. 12 Apr. 2016. <http://library.crossfit.com/free/pdf/CFJ_Wright_Rhabdo.pdf>. This article discusses rhabdomyolysis in an athletic setting, which is important because one of the primary sufferers of the disease are the ones who participate in strenuous activities like CrossFit.
