Rhabdomyolysis: a narrative review
Celia Harumi Tengan, Acary Souza Bulle Oliveira, Alzira Alves de Siqueira Carvalho, Cezar Daniel Snak de Souza, Claudia Ferreira da Rosa Sobreira, Edmar Zanoteli, Helga Cristina Almeida da SilvaAbstract
Rhabdomyolysis is the acute necrosis of striated skeletal muscle, with release of its constituents into the extracellular space and circulation. Acute muscle pain (myalgia), weakness, and edema are associated with serum levels of the muscle enzyme creatine kinase (CK) above 1,000 IU/L or 5 times the upper limit of the normal value. This narrative review provides an overview of the clinical and laboratory findings, etiology, treatment, and prevention of rhabdomyolysis in humans. Additionally, we highlighted the main syndromes and muscular disorders associated with rhabdomyolysis: 1. Clinical syndromes: neuroleptic malignant syndrome, serotoninergic syndrome, sympathomimetic syndrome, malignant hyperthermia, and anesthesia-induced rhabdomyolysis; and 2. Myopathies: toxic myopathies, idiopathic inflammatory myopathies, muscular dystrophies, ion channel diseases, glycogen storage diseases, fatty acid beta oxidation defects, and mitochondrial myopathies.